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麻醉提供者作为围手术期护理中采用药物基因组学信息的利益相关者。

Anesthesia providers as stakeholders to adoption of pharmacogenomic information in perioperative care.

机构信息

Department of Medicine.

Center for Personalized Therapeutics.

出版信息

Pharmacogenet Genomics. 2022 Apr 1;32(3):79-86. doi: 10.1097/FPC.0000000000000455.

Abstract

OBJECTIVES

Integration of pharmacogenomics into clinical care is being studied in multiple disciplines. We hypothesized that understanding attitudes and perceptions of anesthesiologists, critical care and pain medicine providers would uncover unique considerations for future implementation within perioperative care.

METHODS

A survey (multiple choice and Likert-scale) was administered to providers within our Department of Anesthesia and Critical Care prior to initiation of a department-wide prospective pharmacogenomics implementation program. The survey addressed knowledge, perceptions, experiences, resources and barriers.

RESULTS

Of 153 providers contacted, 149 (97%) completed the survey. Almost all providers (92%) said that genetic results influence drug therapy, and few (22%) were skeptical about the usefulness of pharmacogenomics. Despite this enthusiasm, 87% said their awareness about pharmacogenomic information is lacking. Feeling well-informed about pharmacogenomics was directly related to years in practice/experience: only 38% of trainees reported being well-informed, compared to 46% of those with 1-10 years of experience, and nearly two-thirds with 11+ years (P < 0.05). Regarding barriers, providers reported uncertainty about availability of testing, turnaround time and whether testing is worth financial costs.

CONCLUSIONS

Anesthesiology, critical care and pain medicine providers are optimistic about the potential clinical utility of pharmacogenomics, but are uncertain about practical aspects of testing and desire clear guidelines on the use of results. These findings may inform future institutional efforts toward greater integration of genomic results to improve medication-related outcomes.

摘要

目的

多学科正在研究将药物基因组学整合到临床护理中。我们假设,了解麻醉师、重症监护和疼痛医学提供者的态度和看法,将揭示未来在围手术期护理中实施的独特考虑因素。

方法

在我们的麻醉和重症监护部门开始进行一项全部门前瞻性药物基因组学实施计划之前,向该部门的提供者发放了一份调查(多项选择和李克特量表)。该调查涉及知识、看法、经验、资源和障碍。

结果

在联系的 153 名提供者中,有 149 名(97%)完成了调查。几乎所有的提供者(92%)都说基因结果会影响药物治疗,很少(22%)对药物基因组学的有用性持怀疑态度。尽管对此持乐观态度,但 87%的人表示他们对药物基因组学信息缺乏了解。对药物基因组学的了解程度与实践/经验年限直接相关:只有 38%的受训者表示了解情况,而 1-10 年经验的人中这一比例为 46%,11 年以上经验的人中这一比例接近三分之二(P<0.05)。关于障碍,提供者报告说对检测的可用性、周转时间以及检测是否值得花费财务成本存在不确定性。

结论

麻醉学、重症监护和疼痛医学提供者对药物基因组学的潜在临床应用持乐观态度,但对检测的实际方面不确定,并希望有关于使用结果的明确指南。这些发现可能为未来机构努力实现更大程度地整合基因组结果以改善与药物相关的结果提供信息。

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Pharmacogenomics, precision medicine, and implications for anesthesia care.药物基因组学、精准医学及其对麻醉护理的影响。
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