Division of General Internal Medicine, Precision Medicine Program, Department of Medicine, Duke University, Durham, NC 27708, USA.
Durham VA Medical Center, Durham, NC 27705, USA.
Pharmacogenomics. 2024 Feb;25(3):133-145. doi: 10.2217/pgs-2023-0193. Epub 2024 Mar 5.
Understanding barriers and facilitators to pharmacogenomics (PGx) implementation and how to structure a clinical program with the Veterans Health Administration (VA). Healthcare provider (HCP) survey at 20 VA facilities assessing PGx knowledge/acceptance and qualitative interviews to understand how best to design and sustain a national program. 186 (12% response rate) surveyed believed PGx informs drug efficacy (74.7%) and adverse events (71.0%). Low confidence in knowledge (43.0%) and ability to implement (35.4-43.5%). 23 (60.5% response rate) interviewees supported a nationally program to oversee VA education, consultation and IT resources. Prescribing HCPs should be directing local activities. HCPs recognize PGx value but are not prepared to implement. Healthcare systems should build system-wide programs for implementation education and support.
了解实施药物基因组学（PGx）的障碍和促进因素，以及如何与退伍军人健康管理局（VA）构建临床项目。在 20 个 VA 设施对医疗保健提供者（HCP）进行调查，评估 PGx 知识/接受程度，并进行定性访谈，以了解如何最好地设计和维持全国性计划。186 人（12%的回复率）认为 PGx 可以告知药物的疗效（74.7%）和不良反应（71.0%）。知识（43.0%）和实施能力（35.4-43.5%）信心不足。23 人（60.5%的回复率）受访者支持建立一个监督 VA 教育、咨询和 IT 资源的全国性项目。处方医疗保健提供者应指导当地的活动。医疗保健提供者认识到 PGx 的价值，但尚未准备好实施。医疗保健系统应建立全系统的实施教育和支持计划。
