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一线医疗中实施药物遗传学:全科医生对其应用的评估。

Implementation of Pharmacogenetics in First-Line Care: Evaluation of Its Use by General Practitioners.

机构信息

Department of Clinical Chemistry, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands.

Department of Hospital Pharmacy, Erasmus MC University Medical Center, 3015 CN Rotterdam, The Netherlands.

出版信息

Genes (Basel). 2023 Sep 22;14(10):1841. doi: 10.3390/genes14101841.

Abstract

Pharmacogenetics (PGx) can explain/predict drug therapy outcomes. There is, however, unclarity about the use and usefulness of PGx in primary care. In this study, we investigated PGx tests ordered by general practitioners (GPs) in 2021 at Dept. Clinical Chemistry, Erasmus MC, and analyzed the gene tests ordered, drugs/drug groups, reasons for testing and single-gene versus panel testing. Additionally, a survey was sent to 90 GPs asking about their experiences and barriers to implementing PGx. In total, 1206 patients and 6300 PGx tests were requested by GPs. was requested most frequently (17%), and clopidogrel was the most commonly indicated drug (23%). Regarding drug groups, antidepressants (51%) were the main driver for requesting PGx, followed by antihypertensives (26%). Side effects (79%) and non-response (27%) were the main indicators. Panel testing was preferred over single-gene testing. The survey revealed knowledge on when and how to use PGx as one of the main barriers. In conclusion, PGx is currently used by GPs in clinical practice in the Netherlands. Side effects are the main reason for testing, which mostly involves antidepressants. Lack of knowledge is indicated as a major barrier, indicating the need for more education on PGx for GPs.

摘要

药物遗传学(PGx)可以解释/预测药物治疗效果。然而,PGx 在初级保健中的应用和实用性尚不清楚。在这项研究中,我们调查了 2021 年在 Erasmus MC 临床化学系由全科医生(GP)开出的 PGx 测试,并分析了开出的基因测试、药物/药物组、测试原因以及单基因测试与面板测试。此外,我们还向 90 名全科医生发送了一份调查,询问他们在实施 PGx 方面的经验和障碍。总共,GP 要求为 1206 名患者和 6300 次 PGx 测试。CYP2C19 基因检测请求最多(17%),氯吡格雷是最常指示的药物(23%)。关于药物组,抗抑郁药(51%)是要求进行 PGx 的主要驱动因素,其次是降压药(26%)。副作用(79%)和无反应(27%)是主要的指示因素。面板测试比单基因测试更受欢迎。调查显示,何时以及如何使用 PGx 是主要障碍之一。总之,PGx 目前在荷兰的临床实践中由 GP 使用。副作用是测试的主要原因,主要涉及抗抑郁药。缺乏知识表明是一个主要障碍,这表明需要对 GP 进行更多的 PGx 教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af2/10606701/0a30498c0b74/genes-14-01841-g001.jpg

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