Physicians’ Knowledge, Attitude, and Experience of Pharmacogenomic Testing in China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Survey Development
2.2. Survey Population
2.3. Data Analysis
3. Results
3.1. Respondent Characteristics
3.2. Physicians’ Knowledge and Confidence of PGx Testing
3.3. Attitudes towards PGx Testing among Physicians
3.4. Physicians’ Experience with PGx Testing
3.5. Perceived Obstacles and Educational Preferences
4. Discussion
5. Limitation
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
- Ji, Y.; Si, Y.; McMillin, G.A.; Lyon, E. Clinical pharmacogenomics testing in the era of next generation sequencing: Challenges and opportunities for precision medicine. Expert Rev. Mol. Diagn. 2018, 18, 411–421. [Google Scholar] [CrossRef]
- Cacabelos, R.; Cacabelos, N.; Carril, J.C. The role of pharmacogenomics in adverse drug reactions. Expert Rev. Clin. Pharmacol. 2019, 12, 407–442. [Google Scholar] [CrossRef]
- Oslin, D.W.; Lynch, K.G.; Shih, M.C.; Ingram, E.P.; Wray, L.O.; Chapman, S.R.; Kranzler, H.R.; Gelernter, J.; Pyne, J.M.; Stone, A.; et al. Effect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial. Jama 2022, 328, 151–161. [Google Scholar] [CrossRef]
- Sperber, N.R.; Carpenter, J.S.; Cavallari, L.H.; J Damschroder, L.; Cooper-DeHoff, R.M.; Denny, J.C.; Ginsburg, G.S.; Guan, Y.; Horowitz, C.R.; Levy, K.D.; et al. Challenges and strategies for implementing genomic services in diverse settings: Experiences from the Implementing GeNomics In pracTicE (IGNITE) network. BMC Med. Genom. 2017, 10, 35. [Google Scholar] [CrossRef] [Green Version]
- Pérez, V.; Salavert, A.; Espadaler, J.; Tuson, M.; Saiz-Ruiz, J.; Sáez-Navarro, C.; Bobes, J.; Baca-García, E.; Vieta, E.; Olivares, J.M.; et al. Efficacy of prospective pharmacogenetic testing in the treatment of major depressive disorder: Results of a randomized, double-blind clinical trial. BMC Psychiatry 2017, 17, 250. [Google Scholar] [CrossRef] [Green Version]
- Table of Pharmacogenomic Biomarkers in Drug Labeling. Available online: https://www.fda.gov/drugs/science-and-research-drugs/table-pharmacogenomic-biomarkers-drug-labeling (accessed on 31 August 2022).
- Abdullah-Koolmees, H.; van Keulen, A.M.; Nijenhuis, M.; Deneer, V.H.M. Pharmacogenetics Guidelines: Overview and Comparison of the DPWG, CPIC, CPNDS, and RNPGx Guidelines. Front. Pharmacol. 2020, 11, 595219. [Google Scholar] [CrossRef]
- Pereira, N.L.; Rihal, C.S.; So, D.Y.F.; Rosenberg, Y.; Lennon, R.J.; Mathew, V.; Goodman, S.G.; Weinshilboum, R.M.; Wang, L.; Baudhuin, L.M.; et al. Clopidogrel Pharmacogenetics. Circ. Cardiovasc. Interv. 2019, 12, e007811. [Google Scholar] [CrossRef]
- Lucenteforte, E.; Vannacci, A.; Crescioli, G.; Lombardi, N.; Vagnoli, L.; Giunti, L.; Cetica, V.; Coniglio, M.L.; Pugi, A.; Bonaiuti, R.; et al. Opioid response in paediatric cancer patients and the Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene: An Italian study on 87 cancer children and a systematic review. BMC Cancer 2019, 19, 113. [Google Scholar] [CrossRef]
- Hooten, W.M.; Biernacka, J.M.; O’Brien, T.G.; Cunningham, J.M.; Black, J.L. Associations of catechol-O-methyltransferase (rs4680) single nucleotide polymorphisms with opioid use and dose among adults with chronic pain. Pain 2019, 160, 263–268. [Google Scholar] [CrossRef]
- Salm, M.; Abbate, K.; Appelbaum, P.; Ottman, R.; Chung, W.; Marder, K.; Leu, C.-S.; Alcalay, R.; Goldman, J.; Curtis, A.M.; et al. Use of Genetic Tests among Neurologists and Psychiatrists: Knowledge, Attitudes, Behaviors, and Needs for Training. J. Genet. Couns. 2014, 23, 156–163. [Google Scholar] [CrossRef]
- Klitzman, R.; Chung, W.; Marder, K.; Shanmugham, A.; Chin, L.J.; Stark, M.; Leu, C.-S.; Appelbaum, P.S. Attitudes and Practices Among Internists Concerning Genetic Testing. J. Genet. Couns. 2013, 22, 90–100. [Google Scholar] [CrossRef] [Green Version]
- Heale, B.S.E.; Khalifa, A.; Stone, B.L.; Nelson, S.; Del Fiol, G. Physicians’ pharmacogenomics information needs and seeking behavior: A study with case vignettes. BMC Med. Inform. Decis Mak. 2017, 17, 113. [Google Scholar] [CrossRef] [Green Version]
- Haga, S.B.; Burke, W.; Ginsburg, G.S.; Mills, R.; Agans, R. Primary care physicians’ knowledge of and experience with pharmacogenetic testing. Clin. Genet. 2012, 82, 388–394. [Google Scholar] [CrossRef] [Green Version]
- Stanek, E.J.; Sanders, C.L.; Taber, K.A.; Khalid, M.; Patel, A.; Verbrugge, R.R.; Agatep, B.C.; Aubert, R.E.; Epstein, R.S.; Frueh, F.W. Adoption of pharmacogenomic testing by US physicians: Results of a nationwide survey. Clin. Pharmacol. Ther. 2012, 91, 450–458. [Google Scholar] [CrossRef]
- Selkirk, C.G.; Weissman, S.M.; Anderson, A.; Hulick, P.J. Physicians’ preparedness for integration of genomic and pharmacogenetic testing into practice within a major healthcare system. Genet. Test. Mol. Biomark. 2013, 17, 219–225. [Google Scholar] [CrossRef]
- Owusu Obeng, A.; Fei, K.; Levy, K.D.; Elsey, A.R.; Pollin, T.I.; Ramirez, A.H.; Weitzel, K.W.; Horowitz, C.R. Physician-Reported Benefits and Barriers to Clinical Implementation of Genomic Medicine: A Multi-Site IGNITE-Network Survey. J. Pers Med. 2018, 8, 24. [Google Scholar] [CrossRef] [Green Version]
- Muflih, S.; Al-Husein, B.A.; Karasneh, R.; Alzoubi, K.H. Physicians’ Attitudes and Ethical Obligations to Pharmacogenetic Testing. J. Multidiscip. Healthc. 2020, 13, 249–258. [Google Scholar] [CrossRef] [Green Version]
- Luzum, J.A.; Luzum, M.J. Physicians’ attitudes toward pharmacogenetic testing before and after pharmacogenetic education. Per Med. 2016, 13, 119–127. [Google Scholar] [CrossRef] [Green Version]
- Albassam, A.; Alshammari, S.; Ouda, G.; Koshy, S.; Awad, A. Knowledge, perceptions and confidence of physicians and pharmacists towards pharmacogenetics practice in Kuwait. PLoS ONE 2018, 13, e0203033, Erratum in PLoS ONE 2019, 14, e0212118. [Google Scholar] [CrossRef] [Green Version]
- Hu, X.; Jia, T.; Zhang, X.; Wu, C.; Zhang, Y.; Chen, J.; Guan, X.; Shi, L.; Lu, C.Y.; Nie, X. Clinical Pharmacists’ Involvement in Pharmacogenomics Testing and Related Services in China. J. Pers Med. 2022, 12, 1267. [Google Scholar] [CrossRef]
- Elewa, H.; Alkhiyami, D.; Alsahan, D.; Abdel-Aziz, A. A survey on the awareness and attitude of pharmacists and doctors towards the application of pharmacogenomics and its challenges in Qatar. J. Eval. Clin. Pract. 2015, 21, 703–709. [Google Scholar] [CrossRef]
- Bannur, Z.; Bahaman, S.; Salleh, M.Z.; Teh, L.K. Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals. IIUM Med. J. Malays. 2014, 13, 41–50. [Google Scholar] [CrossRef]
- Muzoriana, N.; Gavi, S.; Nembaware, V.; Dhoro, M.; Matimba, A. Knowledge, Attitude, and Perceptions of Pharmacists and Pharmacy Students towards Pharmacogenomics in Zimbabwe. Pharmacy 2017, 5, 36. [Google Scholar] [CrossRef] [Green Version]
- Mills, R.; Haga, S.B. Clinical delivery of pharmacogenetic testing services: A proposed partnership between genetic counselors and pharmacists. Pharmacogenomics 2013, 14, 957–968. [Google Scholar] [CrossRef] [Green Version]
- Williams, M.S. Genomic medicine implementation: Learning by example. Am. J. Med. Genet. C Semin. Med. Genet. 2014, 166c, 8–14. [Google Scholar] [CrossRef]
- Beier, M.T.; Panchapagesan, M.; Carman, L.E. Pharmacogenetics: Has the time come for pharmacists to embrace and implement the science? Consult. Pharm. 2013, 28, 696–711. [Google Scholar] [CrossRef]
- Haidar, C.E.; Petry, N.; Oxencis, C.; Douglas, J.S.; Hoffman, J.M. ASHP Statement on the Pharmacist’s Role in Clinical Pharmacogenomics. Am. J. Health Syst. Pharm. 2022, 79, 704–707. [Google Scholar] [CrossRef]
- Johansen Taber, K.A.; Dickinson, B.D. Pharmacogenomic knowledge gaps and educational resource needs among physicians in selected specialties. Pharmgenomics Pers Med. 2014, 7, 145–162. [Google Scholar] [CrossRef] [Green Version]
- Deininger, K.M.; Tsunoda, S.M.; Hirsch, J.D.; Anderson, H.; Lee, Y.M.; McIlvennan, C.K.; Page, R.L., 2nd; Tran, J.N.; Aquilante, C.L. National survey of physicians’ perspectives on pharmacogenetic testing in solid organ transplantation. Clin. Transplant. 2020, 34, e14037. [Google Scholar] [CrossRef]
- Nie, X.; Jia, T.; Hu, X.; Li, S.; Zhang, X.; Wu, C.; Zhang, Y.; Chen, J.; Shi, L.; Lu, C.Y. Clinical Pharmacists’ Knowledge of and Attitudes toward Pharmacogenomic Testing in China. J. Pers Med. 2022, 12, 1348. [Google Scholar] [CrossRef]
- Yau, A.; Abd Aziz, A.B.; Haque, M. Knowledge, Attitude and Practice Concerning Pharmacogenomics among Pharmacists: A Systematic Review. J. Young Pharm. 2015, 7, 145–154. [Google Scholar] [CrossRef] [Green Version]
- Ho, T.T.; Gift, M.; Alexander, E. Prioritizing pharmacogenomics implementation initiates: A survey of healthcare professionals. Per Med. 2022, 19, 15–23. [Google Scholar] [CrossRef] [PubMed]
- Weitzel, J.N.; Blazer, K.R.; Macdonald, D.J.; Culver, J.O.; Offit, K. Genetics, genomics, and cancer risk assessment. CA A Cancer J. Clin. 2011, 61, 327–359. [Google Scholar] [CrossRef]
- Murphy, L.E.; Fonseka, T.M.; Bousman, C.A.; Müller, D.J. Gene-drug pairings for antidepressants and antipsychotics: Level of evidence and clinical application. Mol. Psychiatry 2022, 27, 593–605. [Google Scholar] [CrossRef]
- Guo, C.; Hu, B.; Guo, C.; Meng, X.; Kuang, Y.; Huang, L.; Wang, D.; Xu, K.; Zhao, Y.; Yang, G.; et al. A Survey of Pharmacogenomics Testing Among Physicians, Pharmacists, and Researchers From China. Front. Pharmacol. 2021, 12, 682020. [Google Scholar] [CrossRef] [PubMed]
- Alzoubi, A.; Kanaan, H.; Alhazaimeh, D.; Gharaibeh, S.; Mukattash, T.L.; Kheirallah, K. Knowledge, attitude, future expectations and perceived barriers of medical students and physicians regarding pharmacogenomics in Jordan. Int. J. Clin. Pract. 2021, 75, e13658. [Google Scholar] [CrossRef]
All Respondents 1 | Respondents Who Have Heard of PGx Before | |
---|---|---|
366 | 275 | |
Gender | ||
Male | 199 (54.4%) | 154(56.0%) |
Female | 167 (45.6%) | 121 (44.0%) |
Age | ||
≤25 | 29 (7.9%) | 12 (4.4%) |
26-35 | 123 (33.6%) | 87 (31.6%) |
36-45 | 142 (38.8%) | 121 (44.0%) |
46-50 | 35 (9.6%) | 25 (9.1%) |
>50 | 37 (10.1%) | 30 (10.9%) |
Highest Educational Qualification | ||
Bachelor’s degree or below | 235 (64.2%) | 158 (57.5%) |
Master’s degree | 102 (27.9%) | 89 (32.4%) |
Doctoral degree | 29 (7.9%) | 28 (10.2%) |
Experience of Study Abroad | ||
Never studied abroad | 344 (94.0%) | 254 (92.4%) |
Studied for a short-term program | 18 (4.9%) | 17 (6.2%) |
Studied for a degree | 4 (1.1%) | 4 (1.5%) |
Work Seniority | ||
<5 year | 126 (34.4%) | 75 (27.3%) |
6–10 years | 70 (19.1%) | 53 (19.3%) |
10–30 years | 148 (40.4%) | 128 (46.6%) |
>30 years | 22 (6.0%) | 19 (6.9%) |
Professional Title | ||
Chief physician | 40 (10.9%) | 37 (13.5%) |
Associate chief physician | 90 (25.1%) | 82 (29.8%) |
Physician-in-charge | 126 (34.4%) | 104 (37.8%) |
Resident physician | 108 (29.5%) | 52 (18.9%) |
Level of Hospital | ||
Tertiary hospital | 197 (53.8%) | 174 (63.3%) |
Secondary hospital | 97 (26.5%) | 71 (25.8%) |
Primary hospital | 23 (6.3%) | 11 (4.0%) |
Other types of medical institutions | 49 (13.4%) | 19 (6.9%) |
Relationship between Hospital and a Medical College | ||
Affiliated hospital | 149 (40.7%) | 122 (44.4%) |
Teaching hospital | 67 (18.3%) | 56 (20.4%) |
Neither affiliated nor teaching hospital | 150 (41.0%) | 197 (35.3%) |
GDP Level of the Province of Practice Location 3 | ||
Middle-low GDP | 63 (17.2%) | 49 (17.8%) |
High GDP | 303 (82.8%) | 226 (82.2%) |
Physicians’ Willingness to Adopt New Technology 2 | ||
Positive | 72 (19.7%) | 60 (21.8%) |
Neutral | 270 (73.8%) | 205 (74.6%) |
Negative | 24 (5.6%) | 10 (3.6%) |
Items of Capability Self-Assessment | Mean Score ± SD 1 |
Evaluate which drugs need pharmacogenomic testing | 3.42 ± 0.08 |
Tailor treatment and monitor regimes based on pharmacogenomic results | 3.40 ± 0.09 |
Recommend pharmacogenomic testing | 3.30 ± 0.09 |
Determine which PGx testing are available at your health care facility | 3.23 ± 0.09 |
Interpret the results of pharmacogenomic testing | 3.20 ± 0.09 |
Areas | Medium | 0–20 | 20–40 | 40–60 | 60–80 | 80–100 |
---|---|---|---|---|---|---|
Targeted cancer therapy | 78.95 ± 1.26 | 7 (2.6%) | 9 (3.3%) | 39 (14.2%) | 74 (26.9%) | 146 (53.1%) |
Cardiovascular diseases | 73.41 ± 1.12 | 3 (1.1%) | 11 (4.0%) | 63 (22.9%) | 103 (37.5%) | 95 (34.6%) |
Rheumatic diseases | 73.30 ± 1.22 | 5 (1.8%) | 15 (5.5%) | 61 (22.2%) | 89 (32.4%) | 105 (38.2%) |
Infectious diseases | 71.02 ± 1.33 | 10 (3.6%) | 15 (5.5%) | 70 (25.5%) | 88 (32.0%) | 92 (33.5%) |
Pain management | 70.64 ± 1.21 | 4 (1.5%) | 17 (6.2%) | 70 (25.5%) | 106 (38.6%) | 78 (28.4%) |
Neurological and psychiatric diseases | 69.89 ± 1.23 | 6 (2.2%) | 18 (6.6%) | 71 (25.8%) | 106 (38.6%) | 74 (26.9%) |
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Jia, T.; Wu, C.; Hu, X.; Li, S.; Zhang, X.; Cai, Y.; Chen, J.; Shi, L.; Lu, C.Y.; Nie, X. Physicians’ Knowledge, Attitude, and Experience of Pharmacogenomic Testing in China. J. Pers. Med. 2022, 12, 2021. https://doi.org/10.3390/jpm12122021
Jia T, Wu C, Hu X, Li S, Zhang X, Cai Y, Chen J, Shi L, Lu CY, Nie X. Physicians’ Knowledge, Attitude, and Experience of Pharmacogenomic Testing in China. Journal of Personalized Medicine. 2022; 12(12):2021. https://doi.org/10.3390/jpm12122021
Chicago/Turabian StyleJia, Tong, Caiying Wu, Xiaowen Hu, Sicong Li, Xinyi Zhang, Yuchun Cai, Jing Chen, Luwen Shi, Christine Y. Lu, and Xiaoyan Nie. 2022. "Physicians’ Knowledge, Attitude, and Experience of Pharmacogenomic Testing in China" Journal of Personalized Medicine 12, no. 12: 2021. https://doi.org/10.3390/jpm12122021