Results
A group of specialty personnel was gathered at the introduction of Precision Medicine ( PM ) at ACH . These specialists included an MD with pharmacogenomics experience , an experienced PGx researcher , an MD informatics technology ( IT ) specialist , an MD director of molecular genetic pathology , an EPIC IT expert , and a project manager . With this PM group and four champion clinicians , the PM group was formed at ACH .
The PGx survey returned 11.67 % ( 131 / 1122 ) responders . Although very few physicians had previously ordered a pharmacogenomic test outside of ACH , a high percentage ( 91.6 %), were eager to learn more about pharmacogenomics . E-learning and department-specific
PowerPoint presentations were preferred education formats ( 61 % of respondents ). In addition , 70 % of responders had reservations about using the PGx test , citing cost ( 24 %) and efficacy ( 18 %) concerns ( Figure 3 ).
Very few providers had ordered a PGx test for their patients , themselves , a colleague , or a family member in the six months previous to the survey ( 7.6 %, 2.3 %, 1.5 %, 0 % respectively ), and of those who had ordered a PGx test , they did so a small number of times over the previous six months ( 90.4 % stated they had not ordered a test ). While 60.8 % of clinicians stated not anticipating ordering the PGx panel in the next six months and 63.8 % noted that they had insufficient PGx knowledge , 39.3 % exhibited an interest in ordering the PGx test in the future . The ACH PM group concluded that the percentage of providers ordering the PGx test would increase as the knowledge of PM increases ; therefore , continuous education was paramount .
It was encouraging to find that almost all ( 99.2 %) of our survey participants realized that a patient ’ s genetic profile could influence his / her response to drug therapy . Only a very few ( 7.0 %) providers had a patient bring in their own PGx or genetic test . As clinicians feel more comfortable about PGx , so will patients .
Patient Genetic Privacy
One of our concerns when issuing the survey to our prescribing clinicians and nurses was how much more concerned they would be about the loss of privacy of a patient ’ s genetic information than from the results of other laboratory or diagnostic tests . With surprising pleasure , the survey showed that most physicians ( 18.0 %) were not concerned since patient health information , including genetic testing and family history , is protected under the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ); in fact , 82 % were anxious to provide this test to their patients . Most clinicians stated that it was important ( 77.7 %) or very important ( 90.8 %) to have specialty-specific guidelines when ordering a pharmacogenomic test ( Figure 4 ). These levels of evidence
Volume 118 • Number 2 august 2021 • 31