Pharmacogenomics and asthma treatment: acceptability to children, families and healthcare professionals

Abstract

BackgroundEvidence supporting personalised treatment for asthma based on an individual’s genetics is mounting. The views of children and young people (CYP), parents and healthcare professionals (HCPs) about this evolution of clinical care are not known.MethodsA pilot prospective questionnaire-based study was undertaken of CYP with asthma, their parents and HCPs at a secondary/tertiary children’s hospital in the UK.ResultsFifty-nine questionnaires were distributed and 50 returned (response rate 84.7%), comprising 26 CYP (10 were 5–11 years, 11 were 12–15 years and 5 were 16–18 years old), 13 parents and 11 HCPs. For all types of data, personal information was ranked as the ‘most important’ (n=19, 47.5%) and ‘most private’ (n=16, 40%), but with considerable variation across groups. Within health data, allergies were rated as ‘most important’ (n=12, 30.8%), and mental health records the ‘most private’ (n=21, 53.8%), again with variation across groups. A ‘personalised genetic asthma plan’ was acceptable to the majority overall (n=40, 80.0%). With regard to sharing CYP’s genetic data, 23 (46%) of participants were happy for unconditional sharing between HCPs, and 23 (46%) agreed to sharing solely in relation to the CYP’s asthma management. Forty-two (84.0%) of participants felt CYP should be informed about genetic data being shared, and the majority felt this should commence by 12 years of age.ConclusionThe use of genetic information to guide management of asthma in CYP is largely acceptable to CYP, parents/guardians and HCPs. However, there are key differences between the opinions of CYP, parents and HCPs.

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

“…In particular, 46% of participants were happy about sharing genetic data with healthcare providers, and 46% agreed to share solely to guide asthma management (42). A relevant issue to address in pharmacogenomics is the identification of genetic markers associated with treatment response in patients with different ethnicities to guide asthma treatment (43).…”

Towards precision drug therapy in asthma

“…A second question regarding implementation of pharmacogenomics in daily practice is whether patients with asthma and/or their parents (in case of children) would accept the sharing of (pharmaco)genetic data. Here we have seen some variation in willingness to share this type of data, varying between around 50% and 80% ( 12 ) and this requires further exploration of perceived privacy issues.…”