Measuring knowledge and attitudes towards the utilization of pharmacogenetic testing among physicians

Abstract

Objective Pharmacogenetic (PGx) testing is a relatively new available diagnostic tool, which aims to prescribe tailored medications based on genetic differences. However, this innovation has been slowly adopted by physicians. This study aims to test Rogers's diffusion of innovation theory to assess knowledge and attitudes towards the use of PGx testing among physicians. Method A sample of community physicians in South Florida was invited to complete an online survey about PGx testing. Practicing physicians who willing to sign the participation letter were included. The survey collected data on sociodemographics, knowledge of and attitudes towards PGx testing. Multiple dimensions of knowledge (i.e. prior experience) and attitude (i.e. relative advantage) were measured. Key findings One hundred and fourty‐eight physicians participated in this study. Physicians’ actual PGx knowledge scores were averaged and significantly predicted by gender (P < 0.01), area of practice (P < 0.01) and prior experience (P < 0.05). The majority of physicians expressed optimistic attitudes towards PGx testing. Attitude scores were significantly predicted by gender (P < 0.05), the relative advantage (P < 0.05) and compatibility (P < 0.01) of testing. Barriers to PGx testing adoption including lack of insurance support, uncertainty about the clinical utility and unavailability of PGx testing at workplace were reported. Conclusions Knowledge of PGx testing among physicians was moderate despite the expressed needs and favourable attitudes. Collaborative efforts to address the potential inhibitors may foster the integration of PGx testing into clinical practice. The need for additional courses and training in the field of pharmacogenetics is warranted.

Pharmacogenomic testing: perception of clinical utility, enablers and barriers to adoption in Australian hospitals

“…The major barriers in implementing pharmacogenomic testing in Australian hospitals, as identified in this study, centred on a lack of knowledge, inadequate guidance and HCP' low confidence in their ability to use and implement pharmacogenomic data in practice. These barriers have been identified previously in other countries 4–6,8,10,15,16,18 in both tertiary 2,9,14,17,20 and primary care 3,7,19,25,26 and align and expand on previous research conducted in Australia more than 7 years ago 17,18 …”

“…Other significant barriers were associated with the HCP' opportunity to test, which could be restricted by their practice environment, social context and available resources (COM-B Opportunity barrier). Reviews of Would not affect (1) Unsure (2) Would affect decision (3) Capability pharmacogenomic implementation studies have found that turnaround times of pharmacogenomic test results might be a challenge to implementation. 27,28 Where noted as a barrier, turnaround times were found to vary from 3 to 42 days.…”

“…The survey (Supporting Information Appendix S1) was adapted from previously published surveys 2,3,5,7,15 and was piloted with six HCP (pharmacists, scientist, registrar, psychology post-doctoral student) for validity. Specific questions were modified to improve clarity and relevance to the Australian healthcare setting (e.g.…”

“…Consistent with this, international studies indicate that healthcare professionals (HCP) report that pharmacogenomic information has clinical utility 2–10 . Despite this, the adoption of pharmacogenomic testing in clinical practice has been limited worldwide 2–8 …”

“…2,4,[8][9][10]20 Training in the clinical application of pharmacogenomic testing has been found to positively impact uptake by HCP. 4,5,10 Additional barriers to the adoption of pharmacogenomic testing include uncertainty about the value of testing, 3,5,8 a lack of clinical practice guidelines, 2,10,19,21 concerns about confidentiality and privacy 3,4,10,20 and cost of insurance cover. 2,[4][5][6]8,10,16,19,20 At an operational level, barriers include absence of supporting infrastructure and readiness of information systems to implement and integrate pharmacogenomic testing into clinical workflows.…”