Adoption of Pharmacogenomic Testing by US Physicians: Results of a Nationwide Survey

Abstract

To develop a benchmark measure of US physicians' level of knowledge and extent of use of pharmacogenomic testing, we conducted an anonymous, cross-sectional, fax-based, national survey. Of 397,832 physicians receiving the survey questionnaire, 10,303 (3%) completed and returned it; the respondents were representative of the overall US physician population. The factors associated with the decision to test were evaluated using χ(2) and multivariate logistic regression. Overall, 97.6% of responding physicians agreed that genetic variations may influence drug response, but only 10.3% felt adequately informed about pharmacogenomic testing. Only 12.9% of physicians had ordered a test in the previous 6 months, and 26.4% anticipated ordering a test in the next 6 months. Early and future adopters of testing were more likely to have received training in pharmacogenomics, but only 29.0% of physicians overall had received any education in the field. Our findings highlight the need for more effective physician education on the clinical value, availability, and interpretation of pharmacogenomic tests.

An Effective Approach to Teaching Pharmacogenomics in the First Year of Pharmacy Curriculum

“…20,21 Some studies report that between 10% and 13% of physicians who participated in the study felt confident with their knowledge. 20,22 There is evidence that supports a deep commitment made by pharmacy educators to provide pharmacogenomics education among all health sciences disciplines. Pharmacists are expected to advise clinicians on matters related to implementation of pharmacogenomics in patient care, 23 and to ensure the use of pharmacogenomics testing when appropriate for medication therapy.…”

A Review of Consent Practices and Perspectives for Pharmacogenetic testing

“…For example, a discussion about testing may not be viewed by patients with the same gravitas as a signed consent form, or patients may fail to recognize it as part of the consent process [62]. Also, the information disclosed in patient-provider discussion may vary substantially due to providers' knowledge [63][64][65][66], so provider education is essential and discussion tips may help standardize discussions. We identified only one guideline on the use of the HER-2 testing that included talking points for discussing test results, but it did not address pretesting communication and consent [67].…”

Framework for development of physician competencies in genomic medicine: report of the Competencies Working Group of the Inter-Society Coordinating Committee for Physician Education in Genomics

“…3,4 The use of genomics in caring for patients with certain cancers and for some pediatric patients is increasing in routine diagnosis and treatment, and this trend is likely to expand to other areas of medical practice in the coming years. 5,6 Nearly half of practicing clinicians in the United States are more than 50 years of age; medical school and residency training for these physicians occurred before the completion of the Human Genome Project and the breakthrough advances in genomic medicine.…”