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Genetic differences in drug responses

Pharmacogenomics testing, the analysis of a patient’s genetic makeup related to the transport, metabolism and targets of drugs, is one of the most important avenues to personalising a patient’s treatment. The ultimate goal of implementing pharmacogenomics testing in patient care is using the patient’s genetic makeup to identify the right drug and dose with the aim of enhancing treatment response, reducing drug-related toxicity and thereby reducing healthcare costs.

In Australia, this goal aligns with Domain 3 (Medicines and management and patient care) of the National Competency Standards Framework for Pharmacists in Australia, which stipulates the scope of practice of a pharmacist. This includes any role that impacts on the safe and effective delivery of services in the profession and use of their professional skills.

This group is interested in identifying genetic targets for both treatment response as well as adverse drug reactions. Identification of genetic markers is just one half of the puzzle. More importantly, the translational of scientific discoveries must bring about change in clinical practice. Hence, this group is also interested in the education of the next generation of healthcare professionals in pharmacogenomics to not only increase the knowledge base of our health workforce, but to also increase the uptake of pharmacogenomics testing within clinical practice.

With the advancement and the reduction in costs for genomic technologies, it is fast becoming a reality to do these projects within a reasonable time frame and budget. This group has been successful in performing both genome wide association studies (GWAS) as well as targeted candidate gene(s) projects. 

The GWAS performed by members of this group was instrumental in the identification of treatment response genetic markers in chronic hepatitis C treatment. Genetic variants identified in this study were able to predict the response rate of individual patients with good accuracy and led to the setting up of the pharmacogenomics testing service for hepatitis C patients intending to get treatment. This service was offered Australia-wide and was widely subscribed by clinicians and patients. In recognition of the clinical utility of this study, this research team was shortlisted for the Australian Museum’s EUREKA award for best translational research in 2011. The second GWAS study carried out by this group was the treatment response GWAS for multiple sclerosis which has identified several genetic markers of interest. 

This group has also been successful in using targeted candidate gene(s) approach in identifying genetic associations with treatment response and adverse effects in rheumatoid arthritis and epilepsy. 

On-going collaborations with various research teams both internal and external to UniSA will offer students interested in translational research plenty of opportunities to work on multidisciplinary end-user targeted research projects that will have major impact on rational use of medications and patient safety.

Current research projects

The teaching and application of pharmacogenomics: Survey of teachers of pharmacogenomics and healthcare practitioners

(PIs: Dr Vijay Suppiah & Dr Catherine King)

There is very little data within the Australian context addressing the attitudes of teachers of therapeutic based courses and practicing pharmacists and medical practitioners regarding the importance of pharmacogenomics – either as a subject that is taught within pharmacy and medical schools, or within the main areas of clinical practice (pharmacy and medical practical within the hospital and community settings). The data that is currently available to us comes from overseas. Any Australian data gathered from this project will inform the knowledge base of current healthcare professionals which can help to shape future medical and pharmacy curricula.

To describe current patterns of medication use in elderly Australians living in aged care residential facilities and independently in communities

(PIs: Dr Vijay Suppiah & Dr Catherine King)

The Australian population is rapidly ageing with longer life expectancies projected. Even though this may be a positive outcome for individuals, it is also possible that increased lifespans and older age may result in increased ill-health which can result in multimorbidity. Multimorbidity is often associated with the use of multiple medicines. Polypharmacy is not only highlighted in relation to the number of medications used, but also the focus includes the use of more medicines than medically necessary, and sometimes, use of inappropriate drug therapy. Concerns have been raised about the consequences of polypharmacy in persons with multimorbidity. Currently, there is a lack of knowledge surrounding the healthcare needs of older Australians.

Mental health, pharmacogenomics and pharmacy practice

(PIs: Dr Vijay Suppiah & Dr Catherine King)

In collaboration with other UniSA academics, community and hospital pharmacists, this study will explore the role of pharmacists in the area of mental health within the community as well as hospital settings. There are several projects at various levels (undergraduate, intern and postgraduate levels).