营养基因组学检测后的医疗专业人员临床措施。
Healthcare Professional Clinical Actions following Nutrigenomics Testing in Practice.
机构信息
School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Québec, Canada.
School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Québec, Canada,
出版信息
Public Health Genomics. 2020;23(5-6):237-245. doi: 10.1159/000511785. Epub 2020 Dec 4.
BACKGROUND
Clinical demand for nutrigenomics testing (NGT) is increasing, underscoring the importance of assessing healthcare professional (HCP) competence and clinical actions with NGT in practice. While previous studies have explored HCP perceptions of NGT, no study has examined real HCP experiences with NGT in practice.
OBJECTIVE
The objective of this study was to evaluate the clinical experience of providing NGT among early adopter HCPs who have used NGT in their practice. We hypothesized that HCP clinical actions after NGT would differ according to HCP personal experience undergoing genetic testing (GT) as well as years in practice.
DESIGN
An online survey questionnaire was administered to HCPs (n = 70) who have provided NGT in practice. χ2 tests, tests for trend, and logistic regression were used to compare HCP characteristics with post-NGT outcomes.
RESULTS
HCPs with fewest years in practice (<5 years) comprised the lowest proportion of respondents (16%). Most HCPs reported good understanding of NGT results and 92% made genetic-based dietary recommendations to patients following NGT. HCP personal use of GT increased significantly with increasing years in practice (<5 years: 36%, 5-10 years: 53%, 11-20 years: 70%, and >20 years: 85%, p trend = 0.003). Requesting patient bloodwork because of NGT results increased significantly with HCP years in practice when HCPs with <5 years in practice were not considered (5-10 years: 19%, 11-20 years: 28%, and >20 years: 60%, p trend = 0.010). A near significant difference was observed where a greater proportion of HCPs who had personally undergone GT reported requesting patient bloodwork (personal use: 46% vs. no personal use: 23%, p-χ2 = 0.066).
CONCLUSION
Early HCP adopters of NGT utilize the test results to provide genetic-based dietary recommendations to patients. Clinical action after NGT currently appears to be driven by HCP years in practice, but HCP personal use of GT may also be a factor.
背景
临床对营养基因组检测（NGT）的需求不断增加，这凸显了评估医疗保健专业人员（HCP）在实践中使用 NGT 的能力和临床操作的重要性。虽然之前的研究已经探讨了 HCP 对 NGT 的看法，但没有研究调查 HCP 在实践中使用 NGT 的真实体验。
目的
本研究旨在评估早期采用者 HCP 在实践中使用 NGT 的临床经验。我们假设，HCP 在进行 NGT 后的临床操作会因 HCP 进行基因检测（GT）的个人经验以及从业年限而有所不同。
设计
向已在实践中提供 NGT 的 HCP（n=70）进行在线问卷调查。χ2 检验、趋势检验和逻辑回归用于比较 HCP 特征与 NGT 后的结果。
结果
从业年限最短（<5 年）的 HCP 构成了比例最低的受访者（16%）。大多数 HCP 表示对 NGT 结果有很好的理解，92%的 HCP 在进行 NGT 后根据基因结果向患者提出了基于遗传的饮食建议。HCP 个人使用 GT 的比例随着从业年限的增加而显著增加（<5 年：36%，5-10 年：53%，11-20 年：70%，>20 年：85%，p 趋势=0.003）。当不考虑从业年限<5 年的 HCP 时，由于 NGT 结果而要求患者进行血液检查的情况随着 HCP 从业年限的增加而显著增加（5-10 年：19%，11-20 年：28%，>20 年：60%，p 趋势=0.010）。有一个接近显著的差异，即更多的个人进行 GT 的 HCP 报告要求患者进行血液检查（个人使用：46%比非个人使用：23%，p-χ2=0.066）。
结论
NGT 的早期采用者利用测试结果向患者提供基于遗传的饮食建议。目前，NGT 后的临床操作似乎主要由 HCP 的从业年限驱动，但 HCP 个人使用 GT 也可能是一个因素。
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