Bollinger Anna, Stäuble Céline K, Urdieux Isabelle O, Meyer Zu Schwabedissen Henriette E, Allemann Samuel S
Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Institute of Hospital Pharmacy, Stadtspital Zürich, Zürich, Switzerland.
J Pain Res. 2025 Sep 5;18:4575-4587. doi: 10.2147/JPR.S543460. eCollection 2025.
Chronic pain is a prevalent and complex condition that often results in inadequate pharmacotherapy due to interindividual variability in drug response. Pharmacogenetics (PGx) offers a promising approach to personalize pain management, particularly since many analgesic drugs are PGx actionable. However, knowledge about the clinical relevance and patient perspective on PGx in Swiss chronic pain care remains limited.
We conducted a cross-sectional online survey among chronic pain patients in the German-speaking regions of Switzerland. The questionnaire was developed to (1) assess the proportion of patients currently or previously treated with PGx actionable drugs, (2) evaluate therapy satisfaction and the perception of being taken seriously by healthcare professionals (HCPs), and (3) explore patients' awareness of PGx and their interest in genetic pain predisposition.
Among the 725 participants who completed the survey, most reported current or past use of PGx actionable drugs: 85% non-steroidal anti-inflammatory drugs (NSAIDs), 54% opioids, 38% co-analgesics (antidepressants), and 73% proton-pump-inhibitors (PPIs) used as adjunctive therapy. Over one-third of participants reported no use of any analgesic drug. Therapy dissatisfaction was reported by 33%, and 28% felt not taken seriously by HCPs. Notably, 97% had never been offered PGx testing by an HCP. Despite this, 60% expressed interest in knowing their genetic pain predisposition, even if it would not affect their treatment. This interest was significantly higher among younger participants and those who were dissatisfied or felt not taken seriously by HCPs.
This study provides the first large-scale, representative insights into the use of PGx actionable drugs and treatment patterns in Swiss chronic pain care. In particular, the high prevalence of PGx actionable drug use and the strong patient interest in genetic information support not only the clinical, but also the biopsychosocial potential of PGx for chronic pain management.
慢性疼痛是一种普遍且复杂的病症，由于药物反应存在个体差异，常常导致药物治疗效果不佳。药物遗传学（PGx）为个性化疼痛管理提供了一种有前景的方法，特别是因为许多镇痛药在药物遗传学方面具有可操作性。然而，在瑞士慢性疼痛护理中，关于药物遗传学的临床相关性和患者观点的知识仍然有限。
我们在瑞士德语区的慢性疼痛患者中进行了一项横断面在线调查。该问卷旨在（1）评估目前或以前接受过药物遗传学可操作药物治疗的患者比例，（2）评估治疗满意度以及对医疗保健专业人员（HCPs）认真对待的认知，（3）探索患者对药物遗传学的认识以及他们对遗传性疼痛易感性的兴趣。
在完成调查的725名参与者中，大多数报告目前或过去使用过药物遗传学可操作药物：85%使用非甾体抗炎药（NSAIDs），54%使用阿片类药物，38%使用辅助镇痛药（抗抑郁药），73%使用质子泵抑制剂（PPIs）作为辅助治疗。超过三分之一的参与者报告未使用任何镇痛药。33%的参与者报告治疗不满意，28%的人感觉未被医疗保健专业人员认真对待。值得注意的是，97%的人从未被医疗保健专业人员提供过药物遗传学检测。尽管如此，60%的人表示有兴趣了解自己的遗传性疼痛易感性，即使这不会影响他们的治疗。这种兴趣在年轻参与者以及那些对治疗不满意或感觉未被医疗保健专业人员认真对待的人中明显更高。
本研究首次对瑞士慢性疼痛护理中药物遗传学可操作药物的使用和治疗模式提供了大规模、有代表性的见解。特别是，药物遗传学可操作药物的高使用率以及患者对遗传信息的强烈兴趣不仅支持了药物遗传学在慢性疼痛管理中的临床潜力，也支持了其生物心理社会潜力。
