Patient-provider communications about pharmacogenomic results increase patient recall of medication changes.,The Pharmacogenomics Journal

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Patient-provider communications about pharmacogenomic results increase patient recall of medication changes.
The Pharmacogenomics Journal ( IF 2.9 ) Pub Date : 2019-02-04 , DOI: 10.1038/s41397-019-0076-2
Brittany A Borden ₁ , Sang Mee Lee ₂ , Keith Danahey _{1,

3} , Paige Galecki ₁ , Linda Patrick-Miller ₄ , Mark Siegler _{1,

4,

5,

6} , Matthew J Sorrentino _{1,

4} , Yasmin Sacro _{1,

4,

7} , Andrew M Davis _{1,

4} , David T Rubin _{1,

4} , Kristen Lipstreuer _{1,

4} , Tamar S Polonsky _{1,

4} , Rita Nanda _{1,

4} , William R Harper _{1,

4,

8} , Jay L Koyner _{1,

4} , Deborah L Burnet _{1,

4} , Walter M Stadler _{1,

4} , Robert T Kavitt _{1,

4} , David O Meltzer _{4,

9} , Mark J Ratain _{1,

4,

6} , Peter H O'Donnell _{1,

4,

6}

Affiliation

Effective doctor-patient communication is critical for disease management, especially when considering genetic information. We studied patient-provider communications after implementing a point-of-care pharmacogenomic results delivery system to understand whether pharmacogenomic results are discussed and whether medication recall is impacted. Outpatients undergoing preemptive pharmacogenomic testing (cases), non-genotyped controls, and study providers were surveyed from October 2012-May 2017. Patient responses were compared between visits where pharmacogenomic results guided prescribing versus visits where pharmacogenomics did not guide prescribing. Provider knowledge of pharmacogenomics, before and during study participation, was also analyzed. Both providers and case patients frequently reported discussions of genetic results after visits where pharmacogenomic information guided prescribing. Importantly, medication changes from visits where pharmacogenomics influenced prescribing were more often recalled than non-pharmacogenomic guided medication changes (OR = 3.3 [1.6-6.7], p = 0.001). Case patients who had separate visits where pharmacogenomics did and did not, respectively, influence prescribing more often remembered medication changes from visits where genomic-based guidance was used (OR = 3.4 [1.2-9.3], p = 0.02). Providers also displayed dramatic increases in personal genomic understanding through program participation (94% felt at least somewhat informed about pharmacogenomics post-participation, compared to 61% at baseline, p = 0.04). Using genomic information during prescribing increases patient-provider communications, patient medication recall, and provider understanding of genomics, important ancillary benefits to clinical use of pharmacogenomics.

中文翻译：

关于药物基因组结果的患者与提供者之间的沟通增加了患者对药物变化的回忆。

有效的医患沟通对于疾病管理至关重要，尤其是在考虑遗传信息时。我们在实施即时药物基因组结果交付系统后研究了患者与提供者之间的沟通，以了解是否讨论了药物基因组结果以及药物召回是否受到影响。从 2012 年 10 月至 2017 年 5 月，对接受抢先药物基因组学检测（病例）、非基因分型对照和研究提供者的门诊患者进行了调查。比较了药物基因组学结果指导处方的就诊与药物基因组学不指导处方的就诊之间的患者反应。还分析了参与研究之前和期间提供者的药物基因组学知识。提供者和病例患者在药物基因组学信息指导处方的访问后经常报告遗传结果的讨论。重要的是，药物基因组学影响处方的访问中的药物变化比非药物基因组学指导的药物变化更容易被回忆起（OR = 3.3 [1.6-6.7]，p = 0.001）。分别进行药物基因组学进行和没有进行单独就诊的病例患者，分别会影响使用基于基因组指导的就诊时更频繁地记住药物变化的处方（OR = 3.4 [1.2-9.3]，p = 0.02）。通过参与计划，提供者还表现出对个人基因组理解的显着提高（94% 的人在参与后至少对药物基因组学有所了解，而基线时这一比例为 61%，p = 0.04）。

更新日期：2019-11-18

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