منیره افضلی

Pharmacogenomics may well have substantial effects on the clinical, economic and regulatory aspects of health sector; which can lead to complications in access. Therefore, there is a need for evidence-based frameworks based on national drug policy components. The objective of the current study is to identify pharmacogenomics-based complications and develop a conceptual model.

The current, is an applied-quantitative study using soft system methodology. The first step adopted scoping review with systematic-search to identify early-adopters experiences. The second used cognitive mapping technique with strategic options development and analysis method using expert panels to assess the relativeness of the challenges and evaluated influence with interpretive structural modeling. In addition, stakeholder mapping was conducted using semi-structured questioners. The third step is used to develop the conceptual model.

Systematic search acknowledged 82 studies for qualitative analysis on the challenges. The identified challenges, which were confirmed by the experts subsequently, were clinical trial protocols, clinical utility of tests and identifying biomarkers in the efficacy/safety component, pricing, coverage and economic assessment in the affordability component, regulations, availability and stakeholders management in the access component and education, guidelines, patient compliance, information technology, bench-to-bedside strategies and ethical/legal/social hazards in the rational use of medicine component. The most influential issue was biomarker validity. The main stakeholder, as the owner and customer, was identified to be the ministry of health. All the results were included in the complicated conceptual model.

The current, was the first study identifying dynamic complications ahead of pharmacogenomics adoption, using soft system methodology. The results may be the basis of the first evidence-based policy on pharmacogenomics, in Iran and other developing countries.

Cancer is one of the chronic diseases in children. Parents of children with cancer, as members of the healthcare team with the special role, need enough information about cancer. The aim of this study was exploring and identifying the information needs of parents of children with cancer.
This was a qualitative research using content analysis method with a phenomenological approach. 14 parents were selected from Children's Medical Center Hospital of Tehran, Iran, and interviewed using semi-depth method for three months. The obtained data were constantly analyzed through constant comparison analysis method.
The obtained data were categorized into 4 themes and 14 subthemes. Medical information about child with cancer, physical healthcare, psycho-educational care, and lifestyle information were the main concerns of parents.
Medical information, psycho-educational, and physical healthcare information have been identified as the most important concerns of parents in relation to the child with cancer. Thus, it seems essential to develop suitable parents’ education plans.