Underrepresented patient views and perceptions of personalized medication treatment through pharmacogenomics

Abstract

Within an institutional pharmacogenomics implementation program, we surveyed 463 outpatients completing preemptive pharmacogenomic testing whose genetic results were available to providers for guiding medication treatment. We compared views and experiences from self-reported White and Black patients, including education level as a covariate across analyses. Black patients were less confident about whether their providers made personalized treatment decisions, and overwhelmingly wanted a greater role for their genetic information in clinical care. Both groups similarly reported that providers asked their opinions regarding medication changes, but White patients were more likely (59% vs. 49%, P = 0.005) to discuss the impact of personal/genetic makeup on medication response with providers, and Black patients reported initiating such discussions much less frequently (4% vs. 15%, P = 0.037). Opportunities exist for enhanced communication with underrepresented patients around personalized care. Tailored communication strategies and development of support tools employed in diverse healthcare settings may facilitate pharmacogenomically guided medication treatment that equitably benefits minority patient populations.

Intersection and Considerations for Patient-Centered Care, Patient Experience, and Medication Experience in Pharmacogenomics

“…In this study, the acceptability of a PGx database was positively associated with a younger age, higher education, higher health literacy, having health insurance, and prior genetic testing experience [25]. Saulsberry et al evaluated underrepresented patient views and perceptions of personalized medication treatment through PGx [26]. Compared to White patients in this study, Black patients were less confident about whether their providers made personalized treatment decisions and were more receptive to the idea of personal genetic information playing a greater role in their clinical care.…”

“…Compared to White patients in this study, Black patients were less confident about whether their providers made personalized treatment decisions and were more receptive to the idea of personal genetic information playing a greater role in their clinical care. Further, compared to White patients, Black patients reported initiating discussions surrounding the impact of personal/genetic makeup with their provider less frequently, indicating the importance of enhanced communication, tailoring communication strategies, and developing support tools to account for variations in patient and medication experience in underrepresented groups [26].…”

How Pharmacogenomics Informs and Influences the Medication Experience

“…Previous work suggests many patients find PGx testing useful and valuable but there is needed improvement in patient-clinician communication and the overall patient experience of care involving PGx. 14 – 18 Specific aspects of PGx testing relevant to patient-clinician communication and the patient experience fit into several of the aforementioned MedXp attributes, which we have categorized as negative, neutral, or positive ( Table 1 ).…”