Effectiveness of Pharmacogenomic-Guided Nursing Interventions on Pain Management and Symptom Control in Oncology Patients: A Review Study

Pharmacogenomic-guided nursing interventions show moderate effectiveness in improving pain management among oncology patients, particularly through CYP۲D۶ genotyping to tailor opioid therapy, with pain improvement rates reaching ۵۶% compared to ۳۰% in historical controls (p < ۰.۰۰۱) in pragmatic pilot trials. In observational cohorts, intermediate and poor CYP۲D۶ metabolizers experienced higher rates of pain-related hospitalizations (odds ratio = ۵.۴; ۹۵% confidence interval, ۱.۲–۲۳.۶; p =.۰۳) without genotyping, underscoring the potential for nurse-led adjustments to reduce such risks. However, evidence for broader symptom control, such as nausea or fatigue, remains limited, with no significant associations reported for ABCB۱ or ABCG۲ polymorphisms in antiemetic efficacy during cisplatin-based chemotherapy. Cancer pain affects up to ۷۰% of advanced oncology patients, often inadequately managed by standard opioids due to genetic variability in drug metabolism, leading to suboptimal relief and increased healthcare utilization; this review synthesizes evidence on nurse-implemented pharmacogenomic strategies to address these gaps. Key secondary findings include the feasibility of nurse-led pharmacogenomic testing in palliative settings, where ۷۳% of patients with actionable genotypes achieved pain improvement, and associations between SNPs in genes like OPRM۱ and COMT with increased daily opioid requirements in advanced cancer. Contradictions arise in studies without explicit nursing roles, showing no overall pain improvement from pharmacogenomics alone (p =.۷۱۶). These findings imply that integrating pharmacogenomic guidance into nursing practice could optimize personalized care, reducing opioid-related hospitalizations and enhancing patient satisfaction, though larger randomized trials are needed to confirm benefits for non-pain symptoms and diverse oncology populations.

کلیدواژه ها:

pharmacogenomics ، nursing ، oncology ، pain management ، opioid ، genetic variation