Pharmacogenetics and the Pharmacy Profession: A Sociological Exploration

Pharmacy, particularly in the community setting, has been subject to significant changes over the last three decades. Running concurrently to these changes has been the development of the field of pharmacogenetics, or ‘personalised medicine’, which is likely to have significant impacts on hospital and community pharmacy practice. Despite this, little sociological research has been undertaken to map the contemporary pharmacy landscape into which pharmacogenetics may be integrated and the effects that pharmacogenetics may have on pharmacy. Through 38 semi-structured interviews with diverse practitioners, this thesis addresses these gaps in the academic literature by positing a novel sociological model through which contemporary pharmacy practice may be analysed and examining the potential impacts of pharmacogenetics on it. It is argued that a dual approach to the management of medicines intersects both community and hospital pharmacy. Within this dual medicines management model, codified, organisational interests in medicines management are practised alongside a more negotiated approach which is enacted through what has been called here the ‘pharmacy gaze’. The pharmacy gaze characterises the ways in which medicines and the patient bodies to which they are administered are co-constructed by pharmacists through discourses of risk and toxicity. Pharmacogenetics, it is argued, represents a way in which the pharmacy gaze, and patient bodies within it, may be increasingly molecularised and risk and toxicity increasingly managed at the genetic level within pharmacy practice. Within this, a number of ‘pharmacogenetic futures’ involving pharmacy testing, patient counselling and practitioner education are presented although these are argued to be highly speculative and to present a number of macro- and micro-level challenges for policy makers and pharmacists. The thesis concludes by making a number of recommendations as to how some of these challenges may be addressed.