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在传达药物遗传学检测结果时保持平衡:促进理解并尽量减少不良心理和行为反应。

Striking a balance in communicating pharmacogenetic test results: promoting comprehension and minimizing adverse psychological and behavioral response.

作者信息

Haga Susanne B, Mills Rachel, Bosworth Hayden

机构信息

Institute for Genome Sciences & Policy and Sanford School of Public Policy, Duke University, Durham, USA.

Institute for Genome Sciences & Policy, Duke University, Durham, USA.

出版信息

Patient Educ Couns. 2014 Oct;97(1):10-5. doi: 10.1016/j.pec.2014.06.007. Epub 2014 Jun 21.

Abstract

OBJECTIVE

Pharmacogenetic (PGx) testing can provide information about a patient's likelihood to respond to a medication or experience an adverse event, and be used to inform medication selection and/or dosing. Promoting patient comprehension of PGx test results will be important to improving engagement and understanding of treatment decisions.

METHODS

The discussion in this paper is based on our experiences and the literature on communication of genetic test results for disease risk and broad risk communication strategies.

RESULTS

Clinical laboratory reports often describe PGx test results using standard terminology such as 'poor metabolizer' or 'ultra-rapid metabolizer.' While this type of terminology may promote patient recall with its simple, yet descriptive nature, it may be difficult for some patients to comprehend and/or cause adverse psychological or behavioral responses.

CONCLUSION

The language used to communicate results and their significance to patients will be important to consider in order to minimize confusion and potential psychological consequences such as increased anxiety that can adversely impact medication-taking behaviors.

PRACTICE IMPLICATIONS

Due to patients' unfamiliarity with PGx testing and the potential for confusion, adverse psychological effects, and decreased medication adherence, health providers need to be cognizant of the language used in discussing PGx test results with patients.

摘要

目的

药物遗传学(PGx)检测能够提供有关患者对药物产生反应或出现不良事件可能性的信息,并用于指导药物选择和/或剂量确定。提高患者对PGx检测结果的理解对于增强其对治疗决策的参与度和理解至关重要。

方法

本文的讨论基于我们的经验以及关于疾病风险基因检测结果沟通和广泛风险沟通策略的文献。

结果

临床实验室报告通常使用“代谢缓慢者”或“超快代谢者”等标准术语来描述PGx检测结果。虽然这类术语因其简单却具有描述性的特点可能有助于患者记忆,但对一些患者来说可能难以理解,和/或引发不良的心理或行为反应。

结论

为尽量减少混淆以及诸如焦虑增加等可能对用药行为产生不利影响的潜在心理后果,考虑用于向患者传达检测结果及其意义的语言非常重要。

实践意义

由于患者对PGx检测不熟悉,且存在混淆、不良心理影响以及用药依从性降低的可能性,医疗服务提供者在与患者讨论PGx检测结果时需要注意所用的语言。

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