Zakinova Angela, Long-Boyle Janel R, French Deborah, Croci Rhiannon, Wilson Leslie, Phillips Kathryn A, Kroetz Deanna L, Shin Jaekyu, Tamraz Bani
School of Pharmacy, University of California San Francisco, San Francisco, CA.
Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA.
J Am Coll Clin Pharm. 2019 Jun;2(3):214-221. doi: 10.1002/jac5.1062. Epub 2018 Nov 22.
Genetic-guided selection of non-oncologic medications is not commonly practiced in general, and at University of California, San Francisco (UCSF) Health, specifically. Understanding the unique position of clinicians with respect to clinical pharmacogenetics (PG) at a specific institution or practice is fundamental for implementing a successful PG consult service.
To assess clinicians' current practices, needs, and interests with respect to clinical PG at UCSF Health, a large tertiary academic medical center.
A list of 42 target medications with clinical PG recommendations was complied. Clinical specialties that routinely used the target medications were identified. A 12-question survey focused on practice of PG for target medications was developed. Pharmacists and physicians were surveyed anonymously in several clinical specialties. Survey results were analyzed using descriptive statistics.
Of the 396 clinicians surveyed, 76 physicians and 59 pharmacists participated, resulting in 27% and 50% average response rates, respectively. The current use of PG in clinical practice for physicians and pharmacists was 29% and 32%, respectively, however this number varied across clinical specialties from 0% to 80%. Of clinicians whom reported they do not currently apply PG, 63% of physicians and 54% of pharmacists expressed interest in integrating PG. However, the level of interest varied from 20% to 100% across specialties. Of the respondents, 64% of physicians and 56% of pharmacists elected to provide contact information to investigators to further discuss their interest related to clinical PG.
While PG is not uniformly practiced at UCSF Health, there is considerable interest in utilizing PG by the respondents. Our approach was successful at identifying clinicians and services interested in PG for specific drug-gene pairs. This work has set a foundation for next steps to advance PG integration at UCSF Health. Clinicians can adopt our approach as preliminary work to build a clinical PG program at their institutions.
一般而言，非肿瘤药物的基因导向选择并不常见，在加利福尼亚大学旧金山分校（UCSF）健康中心尤其如此。了解临床医生在特定机构或实践中相对于临床药物遗传学（PG）的独特地位，是实施成功的PG咨询服务的基础。
评估在大型三级学术医疗中心UCSF健康中心，临床医生关于临床PG的当前实践、需求和兴趣。
编制了一份包含42种有临床PG建议的目标药物清单。确定了常规使用目标药物的临床专科。制定了一项针对目标药物PG实践的12个问题的调查问卷。对几个临床专科的药剂师和医生进行了匿名调查。使用描述性统计分析调查结果。
在接受调查的396名临床医生中，76名医生和59名药剂师参与了调查，平均回复率分别为27%和50%。目前医生和药剂师在临床实践中使用PG的比例分别为29%和32%，然而这一数字在不同临床专科中从0%到80%不等。在报告目前未应用PG的临床医生中，63%的医生和54%的药剂师表示有兴趣将PG纳入其中。然而，各专科的兴趣程度从20%到100%不等。在受访者中，64%的医生和56%的药剂师选择向研究人员提供联系信息，以进一步讨论他们与临床PG相关的兴趣。
虽然PG在UCSF健康中心的实践并不统一，但受访者对利用PG有相当大的兴趣。我们的方法成功地识别出了对特定药物-基因对的PG感兴趣的临床医生和服务。这项工作为UCSF健康中心推进PG整合的下一步工作奠定了基础。临床医生可以采用我们的方法作为在其机构建立临床PG项目的初步工作。
