Underrepresented patient views and perceptions of personalized medication treatment through pharmacogenomics

Loren Saulsberry,Peter H O’Donnell,Brittany A Borden,Keith Danahey,Elizabeth Lipschultz,David O Meltzer,Mark J Ratain,Maimouna Traore

doi:10.1038/s41525-021-00253-1

Loren Saulsberry, Peter H O’Donnell + Show 6 more

Open Access

https://doi.org/10.1038/s41525-021-00253-1

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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.

Highlights

Pharmacogenomic testing is increasingly being incorporated into clinical care as a means to improve drug prescribing, reduce drug inefficacy, and avoid adverse drug events[1,2,3,4,5]
We aimed to explore views and perceptions of care received among genotyped White and Black patients participating in a large institutional pharmacogenomic implementation program
An overwhelming majority of Black patients wanted a greater role for their genetic information in their clinical care

Summary

Introduction

Pharmacogenomic testing is increasingly being incorporated into clinical care as a means to improve drug prescribing, reduce drug inefficacy, and avoid adverse drug events (e.g., toxicity)[1,2,3,4,5]. Pharmacogenomics uses an individual’s unique genetic makeup to assess their potential response to medication treatment, and such tailoring of healthcare delivery is one aspect of modern personalized care. Patient sense of personalized care is a dimension included in existing doctor–patient relationship measurement tools[6]. These and other patient-reported measures have been used to assess quality of care[7,8], and they are increasingly becoming the focus of national health insurance programs like. Pharmacogenomics has been shown to have a significant positive effect on patient perceptions of personalized care and other dimensions of the doctor–patient relationship[10]. Evaluating patients’ experiences with pharmacogenomics as a part of their medical care is critical to determining the clinical utility of genomic medicine

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