The Future of Genomic Testing in Primary Care: The Changing Face of Personalized Medicine

Bartlett, Gillian; Rahimzadeh, Vaso; Longo, Cristina; Orlando, Lori A.; Dawes, Martin; Lachaine, J.; Bochud, Murielle; Paccaud, Fred; Bergman, Howard; Crimi, Laura; Issa, Amalia M.

doi:10.2217/pme.14.36

Cited by 12 publications

(8 citation statements)

References 74 publications

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“…The themes raised may be of particular use to policy makers and commissioners. In order to translate and implement findings from pharmacogenomics research into clinical practice, a multi-pronged approach will be needed (Bartlett et al 2014). Ideally, this should be facilitated by tailored education for primary care clinicians, and the development of electronic decision support systems to enable the integration of genomic and clinical information into the clinical healthcare records (Julia et al 2010).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

The implementation of pharmacogenomics into UK general practice: a qualitative study exploring barriers, challenges and opportunities

et al. 2020

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Pharmacogenomics describes interpatient genetic variability in drug responses. Information based on whole genome sequencing will soon open up the field of pharmacogenomics and facilitate the use of genomic information relating to drug metabolism and drug responses. We undertook a qualitative study, aiming to explore the potential barriers, opportunities and challenges facing the implementation of pharmacogenomics into primary care. Semi-structured interviews were undertaken with 18 clinical participants (16 GPs and 2 other clinicians). All interviews were recorded and transcribed verbatim. Using a thematic analysis approach, data items were coded, ordered and themes constructed. Most participants were aged 55-60 years and worked as part-time clinical GPs with other clearly defined roles. The emerging themes covered several areas of concern, including the following: the utility of pharmacogenomics and the value of introducing such testing into primary care; how to educate the primary care workforce and 'mainstream' pharmacogenomics; the ethical, legal and social aspects of pharmacogenomics and its impact on patients; and potential impacts on the healthcare system particularly around economics and informatics. Most participants had concerns about pharmacogenomics and felt that there were a number of barriers and challenges to its implementation into routine primary care. Most striking were their concerns around the cost-effectiveness of using pharmacogenomics in primary care. At the same time most recognised the increasing availability of direct-to-consumer testing, and felt that this would drive the need to understand the ethical and social implications of using genomic information in primary care. This study has raised important issues that need to be considered when planning the implementation of pharmacogenomics into clinical practice. Prior to the implementation of genomic testing into day-today practice in UK primary care, it is important that considerations around education, cost-effectiveness and informatics are addressed, as well as the impact on patients.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

The implementation of pharmacogenomics into UK general practice: a qualitative study exploring barriers, challenges and opportunities

et al. 2020

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“…breast cancer), preventative genetic testing performed by PCPs can decrease the burden faced by genetic counselors and geneticists 8 . Furthermore, family physicians that have knowledge of a patients' genetic profiles can administer medications more effectively 9 , and have a greater impact on treatment plans 8 . Dr. Gillian Bartlett, Associate Professor at McGill University, focuses her research on the positive impact of implementing genetic services into primary care and works to make this integration possible.…”

Section: Safina Adatiamentioning

confidence: 99%

Integrating Genetic Services into Primary Care: Barriers and Benefits

Adatia¹

2019

hsi

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“…The direct-to-consumer PGx testing gives the patient the ability to become more pro-active in their health care decisions which is an idea that is increasingly popular in our health care system. (Bartlett et al, 2014;Callard et al, 2012;Machini et al, 2014;Mills and Haga, 2013). However the coordination of services among all types of D r a f t providers and the development of PGx practice guidelines require more work (Amstutz and Carleton, 2011;Bartlett et al, 2012;Blancquaert, 2000;McMaster Health Forum, 2012).…”

Section: Stakeholder Roles In Pgxmentioning

confidence: 99%

The 3-I framework: a framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada

Bashir

Ungar

2015

Genome

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The 3-I framework of analyzing the ideas, interests, and institutions around a topic has been used by political scientists to guide public policy development. In Canada, there is a lack of policy governing pharmacogenomics (PGx) testing compared to other developed nations. The goal of this study was to use the 3-I framework, a policy development tool, and apply it to PGx testing to identify and analyze areas where current policy is limited and challenges exist in bringing PGx testing into wide-spread clinical practice in Canada. A scoping review of the literature was conducted to determine the extent and challenges of PGx policy implementation at federal and provincial levels. Based on the 3-I analysis, contentious ideas related to PGx are (i) genetic discrimination, (ii) informed consent, (iii) the lack of knowledge about PGx in health care, (iv) the value of PGx testing, (v) the roles of health care workers in the coordination of PGx services, and (vi) confidentiality and privacy. The 3-I framework is a useful tool for policy makers, and applying it to PGx policy development is a new approach in Canadian genomics. Policy makers at every organizational level can use this analysis to help develop targeted PGx policies.

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The Future of Genomic Testing in Primary Care: The Changing Face of Personalized Medicine

Cited by 12 publications

References 74 publications

The implementation of pharmacogenomics into UK general practice: a qualitative study exploring barriers, challenges and opportunities

The implementation of pharmacogenomics into UK general practice: a qualitative study exploring barriers, challenges and opportunities

Integrating Genetic Services into Primary Care: Barriers and Benefits

The 3-I framework: a framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada

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