Bousman Chad A, Oomen Anita, Jessel Chaten D, Tampi Rajesh R, Forester Brent P, Eyre Harris A, Lavretsky Helen, Müller Daniel J
Department of Medical Genetics, University of Calgary (CAB), Calgary, AB, Canada; Department of Psychiatry, University of Calgary (CAB), Calgary, AB, Canada; Department of Physiology & Pharmacology, University of Calgary (CAB), Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary (CAB, AO), Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary (CAB, CDJ), Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, University of Calgary (CAB, AO), Calgary, AB, Canada.
Am J Geriatr Psychiatry. 2022 May;30(5):560-571. doi: 10.1016/j.jagp.2021.09.013. Epub 2021 Oct 6.
To assess perspectives on pharmacogenetic (PGx) testing among members of the American Association of Geriatric Psychiatry (AAGP).
Cross-sectional survey.
Members of the AAGP.
Anonymous web-based survey consisting of 41 items covering experiences, indications, barriers, facilitators and ethical, legal and social implications for PGx testing.
A total of 124 surveys were completed (response rate = 13%). Most respondents (60%) had used PGx testing but an equal proportion (58%) was uncertain about the clinical usefulness of PGx testing in late-life mental health. Despite self-reported confidence in the ability to order and interpret PGx testing, 60% of respondents felt there was not enough clinical evidence for them to use PGx testing in their practice. This was compounded by uncertainties related to their ethical obligation and legal liability when interpreting and using (or not using) PGx testing results. Respondents strongly affirmed that clinical and legal guidelines for PGx testing in older adults are needed and would be helpful.
The findings suggest additional PGx research and physician education in late-life mental healthcare settings is required to reconcile uncertainties related to the clinical efficacy and ethico-legal aspects of PGx testing as well as address current knowledge barriers to testing uptake. These efforts would be further facilitated by the development of clinical practice guidelines to ensure equitable access to testing and standardized implementation of PGx-informed prescribing in older adults.
评估美国老年精神病学协会（AAGP）成员对药物遗传学（PGx）检测的看法。
横断面调查。
AAGP成员。
基于网络的匿名调查，包含41个项目，涵盖PGx检测的经验、适应症、障碍、促进因素以及伦理、法律和社会影响。
共完成124份调查问卷（回复率 = 13%）。大多数受访者（60%）使用过PGx检测，但同样比例（58%）的人不确定PGx检测在老年心理健康中的临床实用性。尽管自我报告对订购和解读PGx检测的能力有信心，但60%的受访者认为没有足够的临床证据支持他们在实践中使用PGx检测。在解读和使用（或不使用）PGx检测结果时，与伦理义务和法律责任相关的不确定性使情况更加复杂。受访者强烈肯定需要并会有助于制定老年人PGx检测的临床和法律指南。
研究结果表明，在老年心理健康护理环境中需要进行更多的PGx研究和医生教育，以消除与PGx检测的临床疗效以及伦理法律方面相关的不确定性，并解决当前检测应用中的知识障碍。制定临床实践指南将进一步推动这些努力，以确保老年人能够公平获得检测，并实现基于PGx信息的处方的标准化实施。
