Wu Ann Chen, Mazor Kathleen M, Ceccarelli Rachel, Loomer Stephanie, Lu Christine Y
Precision Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, 401 Park Drive, Suite 401, Boston, MA 02215, USA.
Meyers Primary Care Institute, A Joint Endeavor of the University of Massachusetts Medical School, Reliant Medical Group and Fallon Health; 630 Plantation Street, Worcester, MA 02215, USA.
J Pers Med. 2017 Nov 15;7(4):17. doi: 10.3390/jpm7040017.
Genomic tests are the fastest growing sector in medicine and medical science, yet there remains a dearth of research on access to pharmacogenomic tests and medications. The objective of this study is to explore providers' and patients' experiences and views on test access as well as strategies used for gaining access. We interviewed clinicians who prescribed medications that should be guided by pharmacogenomic testing and patients who received those prescriptions. We organized the themes into the four dimensions suggested by the World Health Organization framework on access to medications and health technologies. Guideline-recommended pharmacogenomic tests for cancer care are generally available, although the timeliness of return of test results is sometimes suboptimal. Accessibility of pharmacogenomic tests is made challenging by the process of ordering pharmacogenomic tests, which is time-consuming. Affordability is a barrier to some patients as expressed by both providers and patients, who noted that the cost of pharmacogenomic tests and medications is high. Acceptability of the tests is high as both providers and patients view the tests positively. Understanding challenges to accessing pharmacogenomic tests will allow policymakers to develop policies that streamline access to genomics-based technologies to improve population health.
基因组检测是医学和医学科学领域中发展最快的部门，但在获得药物基因组检测和药物方面的研究仍然匮乏。本研究的目的是探讨提供者和患者在检测获取方面的经历和观点，以及用于获得检测的策略。我们采访了开具应由药物基因组检测指导用药的临床医生和接受这些处方的患者。我们将这些主题按照世界卫生组织关于药物和卫生技术获取框架所建议的四个维度进行了整理。用于癌症护理的指南推荐的药物基因组检测通常是可以获得的，尽管检测结果返回的及时性有时不尽人意。药物基因组检测的订购过程耗时，这使得其可及性面临挑战。提供者和患者都表示，可承受性对一些患者来说是一个障碍，他们指出药物基因组检测和药物的成本很高。检测的可接受性很高，因为提供者和患者都对检测持积极态度。了解获取药物基因组检测的挑战将使政策制定者能够制定政策，简化基于基因组学技术的获取途径，以改善人群健康。
