Ferwerda Maaike E, Wright Jessica A, El Melik Razan M, Swen Jesse J, Houwink Elisa J
Pharmaceutical Sciences, Leiden University, Leiden, Netherlands.
Department of Pharmacy, Mayo Clinic, Rochester, MN, United States.
Front Pharmacol. 2024 Jul 23;15:1404370. doi: 10.3389/fphar.2024.1404370. eCollection 2024.
Pharmacogenomics (PGx) is a well-established concept of how genes impact medication response, with many studies demonstrating reductions in medication side effects, improved efficacy and cost effectiveness. Despite these benefits, implementation of PGx in daily practice remains limited. Studies on the implementation of PGx in clinical practice have previously found that inadequate knowledge is one of the main barriers. Details regarding specifically which educational needs exist among family medicine clinicians requires further study.
The aim of this study was to identify both the perceived role that pharmacogenomics (PGx) could play in primary care practice, the knowledge gaps that family medicine clinicians experience, and the skills they require to use PGx in their daily practice.
To achieve this aim, the attitudes, knowledge, barriers, skills needed, and preferred educational program were explored in a family medicine clinician focus group study via a semi-structured interview and knowledge quiz. Second, multidisciplinary focus groups provided information on the level of knowledge and necessary skills to use PGx in patient care. After gathering key recorded information from both focus groups, the perceived role pharmacogenomics could possibly play in primary care, the predominant knowledge gaps, and the most appropriate educational program was determined by qualitative analysis.
Four themes emerged regarding the PGx educational needs and the role of PGx in family medicine: 1) need for PGx competences, 2) insight into the roles and responsibilities of PGx services, 3) optimization of PGx workflow through artificial intelligence integrated in the electronic health record, and 4) the ethical dilemmas and psychological effects related to PGx. These themes reflect a shift in the role of PGx in family medicine with implications for education.
The results obtained from this study will help improve the implementation of PGx in daily practice, and consequently, may result in increased utilization of PGx, thereby resulting in improved medication efficacy and reduced side effects.
药物基因组学（PGx）是一个已确立的关于基因如何影响药物反应的概念，许多研究表明它能减少药物副作用、提高疗效并具有成本效益。尽管有这些益处，但PGx在日常实践中的应用仍然有限。先前关于PGx在临床实践中应用的研究发现，知识不足是主要障碍之一。家庭医学临床医生具体存在哪些教育需求的细节需要进一步研究。
本研究的目的是确定药物基因组学（PGx）在基层医疗实践中可能发挥的作用、家庭医学临床医生存在的知识差距以及他们在日常实践中使用PGx所需的技能。
为实现这一目标，通过半结构化访谈和知识测验，在家庭医学临床医生焦点小组研究中探讨了态度、知识、障碍、所需技能和偏好的教育项目。其次，多学科焦点小组提供了关于在患者护理中使用PGx的知识水平和必要技能的信息。从两个焦点小组收集关键记录信息后，通过定性分析确定了药物基因组学在基层医疗中可能发挥的作用、主要的知识差距以及最合适的教育项目。
出现了四个关于PGx教育需求以及PGx在家庭医学中作用的主题：1）对PGx能力的需求，2）对PGx服务角色和责任的洞察，3）通过集成在电子健康记录中的人工智能优化PGx工作流程，4）与PGx相关的伦理困境和心理影响。这些主题反映了PGx在家庭医学中作用的转变及其对教育的影响。
本研究获得的结果将有助于改善PGx在日常实践中的应用，从而可能导致PGx的使用增加，进而提高药物疗效并减少副作用。
