Bryan Emma G, Lunsford Kelsey, Mullis Michaela D, McFarlane Antionette, Elwood Erica, Gawronski Brian E, Duarte Julio D, Fisher Carla L
Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL 32511, USA.
J Pers Med. 2024 Nov 29;14(12):1128. doi: 10.3390/jpm14121128.
: The integration of pharmacogenetic (PGx) testing into primary care has not been widely implemented, despite its benefits for patients and providers. PGx testing could also reduce health disparities as patients with lower healthcare access are prescribed higher proportions of medications with PGx guidelines. Little is known about the preferences of patients who have experienced PGx testing to inform implementation across the care process. This qualitative study aimed to refine implementation by capturing patient preferences on (1) testing and prescription timing, (2) patient-clinician discussion of results during post-test counseling, and (3) usability of a card during results dissemination. : Interviews were conducted with 25 primary care patients from clinics primarily serving medically underserved populations. Interview transcripts were thematically analyzed using a constant comparative approach. : While patients supported both reactive and pre-emptive testing, they valued pre-emptive PGx testing because it is , , and is . Patients' preferences for receiving prescriptions depended on several factors: , , and . Patients identified three issues critical to patient-clinician interactions when receiving testing results: , , and . Lastly, they liked that the results card could and but said it lacked . : These findings should inform implementation strategies for integrating PGx testing in primary care for underserved patients.
尽管药物遗传学（PGx）检测对患者和医疗服务提供者有益，但它在初级保健中的整合尚未得到广泛实施。PGx检测还可以减少健康差距，因为医疗服务机会较少的患者在PGx指南的指导下，所开药物的比例更高。对于接受过PGx检测的患者的偏好了解甚少，无法为整个护理过程中的实施提供参考。这项定性研究旨在通过了解患者在以下方面的偏好来优化实施：（1）检测和处方时机；（2）检测后咨询期间患者与临床医生对结果的讨论；（3）结果传播过程中卡片的可用性。对来自主要为医疗服务不足人群服务的诊所的25名初级保健患者进行了访谈。使用持续比较法对访谈记录进行了主题分析。虽然患者支持反应性检测和预防性检测，但他们更看重预防性PGx检测，因为它 ， ，并且 。患者对接受处方的偏好取决于几个因素： ， ，和 。患者确定了接受检测结果时患者与临床医生互动的三个关键问题： ， ，和 。最后，他们喜欢结果卡片可以 和 ，但表示它缺乏 。这些发现应为将PGx检测整合到为服务不足患者提供的初级保健中的实施策略提供参考。
