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评估初级保健临床医生对药物遗传学的知识、认知和实践。

Assessing the knowledge, perceptions, and practices of primary care clinicians toward pharmacogenetics.

作者信息

Johengen Emily K, Ward Kristen M, Coe Antoinette B, Pasternak Amy L

机构信息

Michigan Medicine, Ann Arbor, Michigan.

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan.

出版信息

J Am Coll Clin Pharm. 2021 Jan;4(1):27-32. doi: 10.1002/jac5.1341. Epub 2020 Oct 16.

Abstract

INTRODUCTION

Pharmacogenetics (PGx) testing is becoming increasingly available to patients and clinicians, but investigations of PGx testing in primary care and the pharmacist's role in educating clinicians have been limited.

OBJECTIVES

The objectives of this study were to: (a) determine the utilization of PGx testing in primary care clinics, (b) identify how clinicians document and act on PGx test results, and (c) determine clinician interest in PGx education or consultation from pharmacists.

METHODS

A 16-item survey was distributed via email. Eligible participants included physicians, physician assistants, nurse practitioners, and pharmacists who work in family medicine, general medicine, geriatric, or pediatric primary care clinics at one academic medical center. Descriptive statistics were used to characterize the frequency of PGx tests ordered in primary care clinics, provider comfort with PGx test interpretation, documentation practices, and interest in PGx education or consultation from pharmacists.

RESULTS

The overall survey response rate was 15.8% ( = 55). Most respondents were physicians (84%). Nearly 40% of respondents reported having a patient bring PGx test results to a visit, while only 9% reported ordering a PGx test. Documentation practices were variable, and response to PGx results was most commonly no change in therapy (52%). Only two (3.6%) respondents agreed with the statement, "I feel confident in my ability to interpret PGx test results," and the majority reported interest in PGx education. Eighty percent of respondents reported they would be likely or very likely to consult a PGx-trained pharmacist for help interpreting PGx results.

DISCUSSION

Clinicians in this survey were more likely to have patients bring in results than to order PGx tests, did not feel confident in result interpretation, and expressed interest in working with pharmacists for PGx test interpretation. This research can help guide the development of PGx-focused pharmacy services and education for clinicians who are encountering PGx testing in their practice.

摘要

引言

药物遗传学(PGx)检测越来越多地提供给患者和临床医生,但针对初级保健中PGx检测以及药剂师在教育临床医生方面的作用的研究有限。

目的

本研究的目的是:(a)确定初级保健诊所中PGx检测的使用情况,(b)确定临床医生如何记录PGx检测结果并据此采取行动,以及(c)确定临床医生对药剂师提供的PGx教育或咨询的兴趣。

方法

通过电子邮件分发了一份包含16个条目的调查问卷。符合条件的参与者包括在某学术医疗中心的家庭医学、普通医学、老年医学或儿科初级保健诊所工作的医生、医师助理、执业护士和药剂师。描述性统计用于描述初级保健诊所中开具PGx检测的频率、提供者对PGx检测结果解读的舒适度、记录做法以及对药剂师提供的PGx教育或咨询的兴趣。

结果

总体调查回复率为15.8%(n = 55)。大多数受访者是医生(84%)。近40%的受访者报告有患者在就诊时带来PGx检测结果,而只有9%的受访者报告开具过PGx检测。记录做法各不相同,对PGx结果的反应最常见的是治疗无变化(52%)。只有两名(3.6%)受访者同意“我对自己解读PGx检测结果的能力有信心”这一说法,大多数受访者表示对PGx教育感兴趣。80%的受访者报告他们很可能或非常可能咨询经过PGx培训的药剂师以帮助解读PGx结果。

讨论

本次调查中的临床医生让患者带来检测结果的可能性高于开具PGx检测,对结果解读缺乏信心,并表示有兴趣与药剂师合作解读PGx检测结果。这项研究有助于指导针对在实践中遇到PGx检测的临床医生开展以PGx为重点的药学服务和教育。

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