Racial Differences in Attitudes toward Personalized Medicine

Abstract

Background/Aims: Patient concerns regarding personalized medicine may limit its use. This study assesses racial differences in attitudes toward personalized medicine, evaluating variables that may influence these attitudes. Methods: A convenience sample of 190 adults (≥18 years) from an academic primary care practice was surveyed regarding awareness and acceptance of personalized medicine, plus concerns and benefits regarding its use. Logistic regressions predicting awareness, acceptance and concerns were performed, controlling for race, gender, marital status, education, children, internet use, and self-reported discrimination. Results: The sample was 35% non-Hispanic white (NHW) and 34.7% male. More NHW participants expressed acceptance of personalized medicine than non-Hispanic black (NHB) participants (94.4 vs. 81.9%, p = 0.0190). More NHBs were concerned about the use of genes without consent (57.3 vs. 20.6%, p < 0.0001), sharing genetic information without consent (65.0 vs. 35.6%, p < 0.0001), discrimination based on genes (62.4 vs. 34.3%, p = 0.0002), and lack of access due to cost (75.0 vs. 48.0%, p = 0.0002). In logistic regressions, NHBs (OR = 7.46, 95% CI = 3.04-18.32) and those self-reporting discrimination (OR = 2.87, 95% CI = 1.22-6.78) had more concerns about the misuse of genes and costs associated with personalized medicine. Conclusion: Racial differences exist in attitudes toward personalized medicine and may be influenced by self-reported discrimination. Further study to understand factors influencing the acceptance of personalized medicine could help encourage its use.

Opinions, hopes and concerns regarding pharmacogenomics: a comparison of healthy individuals, heart failure patients and heart transplant recipients

“…Indeed, the former were significantly more preoccupied about the potential negative impact of unfavorable test results on employment and insurability. Previous publications have mentioned these two issues as well, 8,10,11,14,[20][21][22][23][24][25]29,31,33,35,[39][40][41] but our study is the first to indicate that this concern is more prevalent in healthy individuals compared with patients with chronic diseases. Possible explanations for these intergroup differences include the fact that HF patients were older and more frequently retired and that many patients had already been denied insurance coverage due to their chronic illness.…”

“…As in previous publications, 14,21,22,34,40,44 physicians and pharmacists were identified as the most appropriate health-care professionals to handle pharmacogenomic information. Fewer participants indicated that they would grant a similar access to genetic counselors, but this could be explained by the fact that only a minority was aware of the role and responsibilities of these professionals.…”

“…Similar results were observed in previous questionnaires targeting patients with chronic diseases 11,12 or members of the general public. 6,7,9,20,21 On the other hand, a large survey of the British population revealed a certain degree of reticence towards pharmacogenomic testing. 5 Analysis of focus groups and interviews also showed that people generally held positive views of pharmacogenomics.…”

“…Possible explanations for these intergroup differences include the fact that HF patients were older and more frequently retired and that many patients had already been denied insurance coverage due to their chronic illness. Although the group variable was not independently associated with the common fear of disclosure to unauthorized persons, 6,[10][11][12]14,[20][21][22]25,27,29,35,39,41 healthy volunteers appeared to be more worried about this possible lack of confidentiality. These observations are noteworthy, because healthy individuals such as those interviewed in our survey will most likely be the patients of tomorrow.…”

“…Third, because very few people are familiar with pharmacogenomics, basic concepts had to be explained before answering the questionnaire, as in most other survey studies. 6,7,11,12,20,21,38,44 The high approval rate towards pharmacogenomics, however, demonstrates that even a brief education period will most likely be sufficient to make people comfortable with pharmacogenomic testing. Finally, our questionnaire was conducted in a single center in an urban area, which might limit the generalizability of our findings.…”