Aim
Pharmacogenomic (PGx) testing is increasing in precision medicine, however, the role of pharmacists within PGx service delivery remains unclear. This review examined PGx service models to determine whether the role of pharmacists are essential or optional contributors to implementation.
Methods
A PRISMA-guided scoping review of studies published from 2016–2026 across Scopus, Ovid MEDLINE and EMBASE was conducted. Eligible studies described real-world PGx service implementation across tertiary and community settings and reported pharmacist roles. Roles were mapped to PGx service domains: patient referral, pre-test counselling, PGx sampling, medication review, post-test counselling, and follow up. Pharmacists were classified essential where their role was required for service delivery, and optional when pharmacists were described as supplementary support for services that could operate independently without them.
Results
Forty-two studies were included, with 10% (4/42) dedicated to cancer care PGx services. Most services were hospital/tertiary (81%; 34/42), although community pharmacy models are emerging to address patient access barriers. PGx services were more often physician-led (57%; 24/42) than pharmacist-led (43%; 18/42), but pharmacists were identified as having a key role in 76% (32/42) of studies. Although only eight studies (19%) mandate formal PGx training, pharmacist input in PGx delivery was reported essential in 62% (26/42) of studies. Common roles included medication review (76%; 32/42) and post-test counselling (38%; 16/42). In 21% of physician-led studies (5/24), pharmacists contributed to electronic health record (EHR) alerts and PGx guided therapeutic recommendations. Additional pharmacist input included clinician education, referral-based consultation and expansion of clinical pharmacy responsibilities.
Conclusion
PGx services can be both pharmacist-led and physician-led, regardless pharmacists were identified as essential in nearly two-thirds of studies and play critical roles in medication review, result interpretation, patient counselling, clinician education and EHR support. These findings highlight pharmacists are integral to safe, effective and scalable implementation of PGx services.