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

Abstract

Background Despite healthcare professionals (HCP) endorsing the clinical utility of pharmacogenomics testing, use in clinical practice is limited. Aims To assess HCP' perceptions of pharmacogenomic testing and identify barriers to implementation. Methods HCP involved in prescribing decisions at three hospitals in Sydney, Australia, were invited to participate. The online survey assessed perceptions of pharmacogenomic testing, including: (i) demographic and practice variables; (ii) use, knowledge and confidence; (iii) perceived benefits; (iv) barriers to implementation; and (v) operational and/or system changes and personnel required to implement on site. Results HCP were predominantly medical practitioners (75/107) and pharmacists (25/107). HCP perceived pharmacogenomic testing was beneficial to identify reasons for drug intolerance (85/95) and risk of side‐effects (86/95). Although testing was considered relevant to their practice (79/100), few HCP (23/100) reported past or intended future use (26/100). Few HCP reported confidence in their ability to identify indications for pharmacogenomic testing (14/107), order tests (19/106) and communicate results with patients (16/107). Lack of clinical practice guidelines (62/79) and knowledge (54/77) were identified as major barriers to implementation of pharmacogenomics. Comprehensive reimbursement for testing and clinical practice guidelines, alongside models‐of‐care involving multidisciplinary teams and local clinical champions were suggested as strategies to facilitate implementation of pharmacogenomic testing into practice. Conclusions Pharmacogenomic testing was considered important to guide drug selection and dosing decisions. However, limited knowledge, low confidence and an absence of guidelines impede the use of pharmacogenomic testing. Establishment of local resources including multidisciplinary models‐of‐care was suggested to facilitate implementation of pharmacogenomics.

Healthcare professionals' and consumers' knowledge, attitudes, perspectives, and education needs in oncology pharmacogenomics: A systematic review

“…Similar findings were also reported in a recent Australian study conducted by Pearce et al. involving non‐oncology‐specific HCPs, where only less than a quarter of the HCPs surveyed received PGx training as part of their undergraduate curricula 43 . This is reasonable given PGx was/is an emerging field despite personalized medicine being recognized for its potential over 2 decades ago.…”

“…It is possible that the findings may not be generalizable to all HCPs and consumers in oncology as there is evidence that differences exist in the knowledge and practices across different subspecialities, professions, and work settings. 26,29,35 In line with previous studies in noncancer-specific settings, 15,[43][44][45] the results of this systematic review reinforce the notion that utility of PGx testing in oncology is perceived positively by both HCPs and patients. Costs and lack of insurance coverage were found to be the main barriers in adoption of PGx testing in oncology.…”

“…Similar findings were also reported in a recent Australian study conducted by Pearce et al involving non-oncology-specific HCPs, where only less than a quarter of the HCPs surveyed received PGx training as part of their undergraduate curricula. 43 This is reasonable given PGx was/is an emerging field despite personalized medicine being recognized for its potential over 2 decades ago. PGx education in the form of continuing professional education to equip oncology HCPs with requisite translational knowledge and skills, holds the key to bridge the gap in current practice.…”

Clinical Pharmacists’ Knowledge of and Attitudes toward Pharmacogenomic Testing in China

“…To assess clinical pharmacists’ knowledge of and attitudes toward PGx testing, we conducted this survey among clinical pharmacists practicing at tertiary hospitals across mainland China. We found that most Chinese clinical pharmacists who participated in our survey had a relatively good understanding of and positive attitudes toward PGx testing compared with results presented by similar studies in Saudi Arabia [ 23 ] (knowledge score for all participants was 2.4 out of 5.0), Japan [ 24 ] (only 12.5% respondents showed a good understanding of PGx testing), Thailand [ 25 ], Netherlands [ 26 ], and Australia [ 27 , 28 ] (6–21% pharmacists have knowledge about PGx testing).…”

Knowledge, perceptions, and attitudes toward pharmacogenomics among pharmacists and pharmacy students: A systematic review

“…35,39,45,47,48,53,56,58,59,83,84 Out of the 34 studies that reported on PGx knowledge or awareness among pharmacists, 23 found that the majority of the respondents had a low or inadequate level of PGx knowledge or awareness. 31,[35][36][37][38]41,44,46,47,[50][51][52]54,55,57,59,60,66,67,76,82,83,85 None of the analyzed studies reported that most respondents had adequate PGx knowledge. In comparison, most studies with pharmacy students found a good or fair level of knowledge among most participants.…”