Feasibility of CYP2C19-guided clopidogrel therapy in community pharmacy: a systematic review
Abstract
Background/ObjectivesPharmacogenetic (PGx) testing holds promise for improving drug efficacy and safety by tailoring therapy to patients’ genetic profiles. One of the most clinically relevant applications is CYP2C19 testing to guide clopidogrel therapy, particularly in cardiovascular patients. As accessible healthcare settings, community pharmacies may provide a practical model for delivering PGx services. This systematic review evaluates the feasibility of implementing CYP2C19 genetic testing for clopidogrel management in community pharmacy settings.MethodsA systematic search of PubMed, ProQuest, Cochrane Central, Scopus, and EBSCO was conducted from inception to 23 December 2025, following PRISMA guidelines. Eligible studies assessed CYP2C19 testing in community pharmacies. Outcomes of interest included clinical, operational, economic, patient-reported, and provider-reported measures.ResultsOf 42 studies initially screened, three prospective studies met the inclusion criteria. All evaluated pharmacist-led CYP2C19 testing models in community pharmacies. Testing success rates were high (98%–100%). However, only the point-of-care testing enabled rapid turnaround times. Patient-reported perceptions were generally favorable, with most considering pharmacies appropriate for PGx testing. Pharmacists reported added clinical value but cited barriers such as reimbursement challenges, workflow integration, and knowledge gaps. Economic findings were mixed: point-of-care testing showed potential cost savings at higher rates of genotype-guided therapy modification, while reimbursement limitations hindered implementation in other settings.ConclusionCommunity pharmacy-based PGx testing for clopidogrel provides preliminary evidence supporting operational feasibility. To support sustainable implementation, efforts should focus on establishing funding mechanisms, enhancing provider education, and integrating PGx testing into routine workflows.
Related
- What Happens to the General Practitioner When the Pharmacist Tests for Strep Throat? A Systematic Review of Community Pharmacy Sore Throat Services and Their Consequences for General Practice.
- PO023 | CLOPIDOGREL USE IN ANTIPLATELET MANAGEMENT OF ESSENTIAL THROMBOCYTHEMIA (TECLA STUDY): DESIGN AND FEASIBILITY OF A SINGLE-CENTRE STUDY
- Modifiable drivers of community pharmacy closures in Colorado and Utah: a qualitative focus group study.
- Quality Assurance in Pharmacy Education in the East African Community: National Accreditation, Regional Harmonization, and Continuous Improvement
- Building on the 2025 national academies pharmacy workshop: ensuring access to community pharmacist care.
BibTeX
@article{mohammed2026feasibility,
title = {{Feasibility of CYP2C19-guided clopidogrel therapy in community pharmacy: a systematic review}},
author = {Shaban Mohammed and Nermin Mohammed and Zainab Ali and Yaser Ghariba and Wadha Al-Muftah and Rania Abdel-Latif and Ayman El-Menyar and Maw Shin Sim},
journal = {Frontiers in Pharmacology},
year = {2026},
month = nov,
doi = {10.3389/fphar.2026.1871437},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1871437},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Feasibility of CYP2C19-guided clopidogrel therapy in community pharmacy: a systematic review
AU - Shaban Mohammed
AU - Nermin Mohammed
AU - Zainab Ali
AU - Yaser Ghariba
AU - Wadha Al-Muftah
AU - Rania Abdel-Latif
AU - Ayman El-Menyar
AU - Maw Shin Sim
PY - 2026
DA - 2026/11/05
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1871437
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1871437
AB - Background/ObjectivesPharmacogenetic (PGx) testing holds promise for improving drug efficacy and safety by tailoring therapy to patients’ genetic profiles. One of the most clinically relevant applications is CYP2C19 testing to guide clopidogrel therapy, particularly in cardiovascular patients. As accessible healthcare settings, community pharmacies may provide a practical model for delivering PGx services. This systematic review evaluates the feasibility of implementing CYP2C19 genetic testing for clopidogrel management in community pharmacy settings.MethodsA systematic search of PubMed, ProQuest, Cochrane Central, Scopus, and EBSCO was conducted from inception to 23 December 2025, following PRISMA guidelines. Eligible studies assessed CYP2C19 testing in community pharmacies. Outcomes of interest included clinical, operational, economic, patient-reported, and provider-reported measures.ResultsOf 42 studies initially screened, three prospective studies met the inclusion criteria. All evaluated pharmacist-led CYP2C19 testing models in community pharmacies. Testing success rates were high (98%–100%). However, only the point-of-care testing enabled rapid turnaround times. Patient-reported perceptions were generally favorable, with most considering pharmacies appropriate for PGx testing. Pharmacists reported added clinical value but cited barriers such as reimbursement challenges, workflow integration, and knowledge gaps. Economic findings were mixed: point-of-care testing showed potential cost savings at higher rates of genotype-guided therapy modification, while reimbursement limitations hindered implementation in other settings.ConclusionCommunity pharmacy-based PGx testing for clopidogrel provides preliminary evidence supporting operational feasibility. To support sustainable implementation, efforts should focus on establishing funding mechanisms, enhancing provider education, and integrating PGx testing into routine workflows.
SN - 1663-9812
ER -