Genomics and Pharmacogenomics Knowledge, Attitude and Practice of Pharmacists Working in United Arab Emirates: Findings from Focus Group Discussions—A Qualitative Study

Round 1

Reviewer 1 Report

In this manuscript Rahma et al. described the road map for the implementation of pharmacogenomics and genomic medicine based approach in UAE respect to the role of pharmacist in this scenario.
i have just a comment: in the discussion is need to refer to public database with all pharmacogenomics data on drugs and gene polymorphic variants for a best framing of the problem.

Plagiarism was detected.

Author Response

• In this manuscript Rahma et al. described the road map for the implementation of pharmacogenomics and genomic medicine-based approach in UAE respect to the role of pharmacist in this scenario. I have just a comment: in the discussion is need to refer to public database with all pharmacogenomics data on drugs and gene polymorphic variants for a best framing of the problem.

This is really a valid point, that added strength and value to the discussion. To cover this point, we added the following (line 338-348)

Pharmacists in UAE are thirsty for resources and tools to foster their competency in genomics and pharmacogenomics. The Implementing GeNomics In praTticE (IGNITE Toolbox) is one of many open peer reviewed resources that consolidate the knowledge and implantation efforts of pharmacists and other healthcare providers. Clinical Pharmacogenetics Implementation Consortium (CPIC) provides guidelines on converting genetics results to actionable interventions. Accompanied by the PharmGKB which grant knowledge incorporated in pathways.

Scholars are equipping healthcare providers with tools to overcome the gap in their knowledge. Zarei S. et al coined a web-based pharmacogenomics search Instrument for the pharmacogenomics of drugs used in anesthesia. The Genotype-Tissue Expression (GTEx) Consortium is another resource.

• Plagiarism was detected:

We run the paper through two tools to detect plagiarism Grammarly and ithenticate index. Reports is captured below for ithenticate index and attached for both ithenticate index and Grammarly.

The similarity is within the header and the footnote added automatically by the journal’s formatting.

Reviewer 2 Report

Azhar Rahma et al in this work described a Qualitative method using focus group discussions (FGDs)  conducted among pharmacists working in public and private hospitals in Abu Dhabi Emirate and Thematic inductive analysis by two  independent researchers. They found that  knowledge of genomics and pharmacogenomics as well as attitude and practice among pharmacists needs to be improved. Therefore, they recommend introducing new courses and training workshops for healthcare providers to improve the opportunity of genomics and pharmacogenomics applications in the UAE. The study is generally good for raising the issues of pharmacists in the UAE, and they also provided some solutions, however, the solutions they provide should be more collected and detailed. They need to compare UAE and some other countries that could provide better examples for UAE.

Author Response

Azhar Rahma et al in this work described a Qualitative method using focus group discussions (FGDs)  conducted among pharmacists working in public and private hospitals in Abu Dhabi Emirate and Thematic inductive analysis by two  independent researchers. They found that  knowledge of genomics and pharmacogenomics as well as attitude and practice among pharmacists needs to be improved. Therefore, they recommend introducing new courses and training workshops for healthcare providers to improve the opportunity of genomics and pharmacogenomics applications in the UAE. The study is generally good for raising the issues of pharmacists in the UAE, and they also provided some solutions, however, the solutions they provide should be more collected and detailed. They need to compare UAE and some other countries that could provide better examples for UAE.

This feedback empowers the conclusion, as we detailed and numbered the recommended solutions (line 387-393)

We recommend: 1. Inaugurating mandatory pharmacogenomics’ competency for pharmacists in UAE. 2. Lunching courses and workshops in collaboration with universities. 3. Encompassing pharmacists as a key stakeholder in the piloting phase of the implementation of pharmacogenomics.4. Constructing algorithms and guidelines to guide pharmacists.5. Fostering electronic decision support system and configurating it with the pharmacist’ interface. 6. Assembling regular focus group discussions with pharmacists to identify and address their needs and challenges.

With regard to “They need to compare UAE and some other countries that could provide better examples for UAE.” We did impute the following studies and implementation strategies and that added a layer of strength to our paper , so thank you so much. (line 326-337) and (350-358)

Myriad of studies postulated the feasibility of pharmacists’ role in implementing pharmacogenomics at bed side and health settings. A pilot study by Bank PC et al in the Netherlands underscored the efficient role of community pharmacists in recommending intervention based on the drug-gene of the patients and these recommendations were acknowledged by the clinicians in 88.7% of the patients.

Stark Z. et al advocated the global liability of transforming genomics into healthcare. In their paper they delignated the different implementation strategies taken by 15 countries namely : UK, France, Australia, Saudi Arabia, ,Turkey ,US, Estonia, Denmark, Japan, Qatar , Switzerland, the Netherlands, Brazil, , Finland and China. These strategies and initiatives can be tools for the adoption of genomic medicine and pharmacogenomics in the UAE to avoid reinventing the wheels and squandering resources.

Ziegelstein RC in his commentary diagnosed personomics as the gap of the adoption and evolution of personalized medicine. In consonance with this punchline, we hypothesize that the healthcare providers and more specifically pharmacists are rooted in the personomics concept. And addressing their knowledge, attitude and perception will reshape the face of medicine in the country.

As recommended by the 9th Santorini Conference conducted in Greece, establishing a research link among academic and business will bridge the gaps and chasm in the roadmap for full implementation of genomic medicine and pharmacogenomics. These recommendations can guide UAE in its strategy for implementing genomic medicine and pharmacogenomics.

Round 2

Reviewer 2 Report

The concerns have been addressed.