Improving Stroke Care in Wales Through Genomic Testing
A new feasibility project has launched at the University Hospital of Wales (UHW) , Cardiff, which explores the impact of using CYP2C19 genetic testing before prescribing clopidogrel in stroke care. This follows new guidance from NICE (National Institute for Health and Care Excellence), which recommends genetic testing for all patients who have had a stroke or mini-stroke and are due to begin clopidogrel treatment. The goal is to reduce the risk of further strokes and improve patient outcomes by guiding more effective treatment choices.
CYP2C19 genetic testing looks for specific changes in the CYP2C19 gene, which affect how a person processes certain medications — particularly clopidogrel, an antiplatelet drug used to help prevent blood clots.
The testing began in May of this year and is led by Wales’ National Pharmacogenomics Group, in partnership with the UHW Stroke Team, the All-Wales Medical Genomics Service, and supported by the NHS Wales Stroke Implementation Network.
The project is evaluating how practical it is to include CYP2C19 testing as part of routine stroke care. It is looking at how quickly results can be delivered, effective coordination between laboratories and clinical teams, and how testing affects patient care overall. The aim is to help ensure patients receive the most appropriate antiplatelet treatment based on their genetic profile.
Beyond patient care, the project also supports staff development by highlighting areas where they can integrate precision medicine into routine practice. It provides hands-on experience in using genetic testing to inform clinical decisions and promotes collaboration across multidisciplinary teams. Insights gained from the project over the next six months will be used to shape a similar approach across all of Wales, which the National Pharmacogenomics Group and the NHS P&I Stroke Implementation Network are now exploring implementing alongside other NHS partners.
Dr Sophie Harding, Consultant Pharmacist for Genomics & Pharmacogenomics in Wales said:
“This work supports the Welsh Government’s Genomics Delivery Plan, which aims to make better use of genomics to improve how medicines are used in the NHS. It will also contribute to the upcoming Pharmacogenomics Delivery Plan, setting out the next three years of work to establish an NHS pharmacogenomics service for Wales — ensuring equitable access to testing across the UK and alignment with developments in other nations for the benefit of patients.”
As part of Genomics Literacy Week, we hosted a series of webinars for NHS professionals alongside Heath Education and Improvement Wales (HEIW). These included a session on stroke care- exploring the latest developments in pharmacogenomics and how it will support stroke care in Wales in the near future.
Recordings of all webinars will be available to view on the HEIW website.