Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality - 25/09/16
, Suzette J. Bielinski, PhD a, Janet E. Olson, PhD a, Elizabeth J. Bell, PhD a, Michaela E. Mc Gree, BS b, Debra J. Jacobson, MS b, Jennifer B. McCormick, PhD c, Pedro J. Caraballo, MD d, Paul Y. Takahashi, MD e, Veronique L. Roger, MD f, Carolyn R. Rohrer Vitek, MS gAbstract |
Background |
Limited information is available regarding primary care clinicians' response to pharmacogenomic clinical decision support (PGx-CDS) alerts integrated in the electronic health record.
Methods |
In February 2015, 159 clinicians in the Mayo Clinic primary care practice were sent e-mail surveys to understand their perspectives on the implementation and use of pharmacogenomic testing in their clinical practice. Surveys assessed how the clinicians felt about pharmacogenomics and whether they thought electronic PGx-CDS alerts were useful. Information was abstracted on the number of CDS alerts the clinicians received between October 2013 and the date their survey was returned. CDS alerts were grouped into 2 categories: the alert recommended caution using the prescription, or the alert recommended an alternate prescription. Finally, data were abstracted regarding whether the clinician changed their prescription in response to the alert recommendation.
Results |
The survey response rate was 57% (n = 90). Overall, 52% of the clinicians did not expect to use or did not know whether they would use pharmacogenomic information in their future prescribing practices. Additionally, 53% of the clinicians felt that the alerts were confusing, irritating, frustrating, or that it was difficult to find additional information. Finally, only 30% of the clinicians that received a CDS alert changed their prescription to an alternative medication.
Conclusions |
Our results suggest a lack of clinician comfort with integration of pharmacogenomic data into primary care. Further efforts to refine PGx-CDS alerts to make them as useful and user-friendly as possible are needed to improve clinician satisfaction with these new tools.
Le texte complet de cet article est disponible en PDF.Keywords : Clinical practice patterns, Genomics, Pharmacogenetics, Practice patterns
Plan
| Funding: This research was funded by the Mayo Clinic Center for Individualized Medicine and the Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. |
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| Conflict of Interest: The authors have no conflicts of interest to report. |
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| Authorship: All authors had access to the data and a role in writing the manuscript. |
Vol 129 - N° 10
P. 1093 - octobre 2016 Retour au numéro
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