Patient perceptions of care as influenced by a large institutional pharmacogenomic implementation program

摘要

Despite growing clinical use of genomic information, patient perceptions of genomic-based care are poorly understood. We prospectively studied patient-physician pairs who participated in an institutional pharmacogenomic implementation program. Trust/Privacy/Empathy/Medical Decision-Making (MDM)/Personalized Care (PC) dimensions were assessed through patient surveys after clinic visits at which physicians had access to preemptive pharmacogenomic results (Likert scale, 1-minimum/5-maximum; mean [SD]). From 2012–2015, 1,261 surveys were issued to 507 patients, with 792 (62.8%) returned. Privacy, Empathy, MDM and PC scores were significantly higher following visits when physicians considered pharmacogenomic results. Importantly, PC scores were significantly higher after physicians used pharmacogenomic information to guide medication changes (4.0[1.4] vs. 3.0[1.6], P<0.001) compared to prescribing visits without genomic guidance. Multivariable modeling controlling for clinical factors confirmed PC scores were more favorable following visits with genomic-influenced prescribing (OR=3.26 [1.31–8.14], P<0.05). Physicians appear to individualize care when utilizing pharmacogenomic results and this decision-making augmentation is perceived positively by patients.