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Medication adjustments in 7 out of 3 patients as a result of pharmacogenetic testing initiated by primary care pharmacists based on specific inclusion protocols (SA-PGx pilot) Background Pharmacogenetic analysis is currently performed at 16 certified laboratories in the Netherlands. For 90 different drugs pharmacogenetic advice is available, of which 23 drugs are frequently prescribed in primary care. Despite these opportunities the use of pharmacogenetic testing in primary care is still limited. Objective Investigate to what extent pharmacogenetic inclusion protocols and expert opinion of a pharmacist will lead to medication adjustments in patients. Design Prospective feasibility cohort study. Methods Eligible patients for pharmacogenetic testing are selected based on predefined inclusion protocols or pharmacist's expert opinion. DNA analysis is performed on buccal swab material collected in the pharmacy. Questionnaires, regarding drug-related complaints and patient satisfaction concerning provided care in the pharmacy, are filled in by the patients at baseline and after 1-2 weeks (no medication adjustments) or after 6 weeks (medication adjustments). Following study completion the application of pharmacogenetic testing is evaluated by the participating pharmacists. Results Over a period of 2 years 86 patients were included within 10 primary care pharmacies. Medication changes based on pharmacogenetic results were registered in 25 patients (29%). Almost 1/3 of these patients were selected based on the inclusion protocols. The most frequently changed drugs were clopidogrel, statins, pantoprazole and metoprolol. Drug complaints were reduced in 19% (n = 3) of the patients (not significant). The lack of imbursement in case of pharmacogenetic test requests from pharmacists was the most frequently mentioned barrier towards broad implementation of pharmacogenetics in primary care pharmacy. Conclusion Pharmacogenetic requests initiated by the pharmacist lead to medicatio