O'Shea Joseph, Ryan Cristín, Gallagher Joseph, O'Brien Claire, Morris Conor, Dwyer Eoin, Laughlin James Mc, Fitzpatrick Laura, O'Meara Maire, Kelly Sarah, Knox Sophie, Ledwidge Mark
School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
Explor Res Clin Soc Pharm. 2022 Sep 21;8:100182. doi: 10.1016/j.rcsop.2022.100182. eCollection 2022 Dec.
As pharmacogenomic services begin to emerge in primary care, the insight of the public is crucial for its integration into clinical practice.
To establish perceptions of pharmacogenomics (awareness, understanding, openness to availability, perceived benefits and concerns, willingness to pay, and service setting) and investigate if they differ between those with and without chronic disease(s).
An anonymous, online questionnaire generated using Qualtrics® and circulated via social media and posters placed in eight participating community pharmacies was conducted with Irish adults. The questions were designed to consider existing literature on patient perceptions of pharmacogenomics. Descriptive statistics were used to summarize questionnaire responses. Chi-square test was used to compare categorical variables, while independent sample -test and one-way ANOVA were used to compare the mean values of two (with and without chronic disease) and three groups (multimorbidity (two or more chronic conditions) and polypharmacy (prescribed four or more regular medicines) (MMPP), a single chronic disease, and those without existing medical conditions) respectively Logistic regression was used to evaluate age and gender adjusted associations of chronic disease(s) with responses. A -value <0.05 was considered statistically significant.
A total of 421 responses were received, 30% ( = 120) of whom reported having a chronic disease. Overall, respondents reported low awareness (44%, = 166) and poor knowledge (55%, = 212) of pharmacogenomics. After explaining pharmacogenomics to respondents, patients with chronic disease(s) were 2.17 times more likely ( < 0.001) to want pharmacogenomic services availability than those without existing conditions, adjusted for age and gender (driven by preferences of those with MMPP than those with single chronic disease). Respondents demonstrated a high level of interest and noted both the potential benefits and downsides of pharmacogenomic testing. Willingness-to-pay was not associated with having a chronic disease and respondents were more positive about primary care (community pharmacy or general practice) rather than hospital-based pharmacogenomics implementation.
The Irish public in general and those with chronic disease in particular are strongly supportive of pharmacogenomic testing, highlighting an unmet need for its incorporation in medicines optimization. These data underline the need for more research on the implementation of community-based pharmacogenomics services for MMPP patients and ubiquitous pharmacogenomics education programs.
随着药物基因组学服务开始在初级保健中出现，公众的见解对于其融入临床实践至关重要。
确定对药物基因组学的看法（知晓度、理解程度、对可获得性的接受度、感知到的益处和担忧、支付意愿以及服务环境），并调查患有和未患有慢性病的人群之间是否存在差异。
使用Qualtrics®生成一份匿名在线问卷，并通过社交媒体以及放置在八家参与调查的社区药房的海报，向爱尔兰成年人进行发放。问题的设计参考了关于患者对药物基因组学看法的现有文献。描述性统计用于总结问卷回复。卡方检验用于比较分类变量，而独立样本t检验和单因素方差分析分别用于比较两组（患有和未患有慢性病）以及三组（多种疾病并存（两种或更多慢性疾病）和多种药物联用（开具四种或更多常规药物）（MMPP）、单一慢性疾病以及无现有疾病）的均值。逻辑回归用于评估年龄和性别调整后的慢性病与回复之间的关联。P值<0.05被认为具有统计学意义。
共收到421份回复，其中30%（n = 120）报告患有慢性病。总体而言，受访者报告对药物基因组学的知晓度较低（44%，n = 166）且了解程度较差（55%，n = 212）。在向受访者解释药物基因组学之后，经年龄和性别调整（受MMPP患者而非单一慢性疾病患者的偏好驱动），患有慢性病的患者希望获得药物基因组学服务的可能性是无现有疾病患者的2.17倍（P < 0.001）。受访者表现出高度兴趣，并指出了药物基因组学检测的潜在益处和弊端。支付意愿与患有慢性病无关，并且受访者对初级保健（社区药房或全科医疗）实施药物基因组学比基于医院的实施更为积极。
爱尔兰公众总体上，尤其是患有慢性病的人群，强烈支持药物基因组学检测，突出了将其纳入药物优化方面存在未满足的需求。这些数据强调需要对为MMPP患者实施基于社区的药物基因组学服务以及普及药物基因组学教育项目进行更多研究。
