Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality

Jennifer L. St. Sauver, Suzette J. Bielinski, Janet E. Olson, Elizabeth J. Bell, Michaela E. Mc Gree, Debra J. Jacobson, Jennifer B. McCormick, Pedro J. Caraballo, Paul Y. Takahashi, Veronique L. Roger, Carolyn R. Rohrer Vitek

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background Limited information is available regarding primary care clinicians’ response to pharmacogenomic clinical decision support (PGx-CDS) alerts integrated in the electronic health record. Methods In February 2015, 159 clinicians in the Mayo Clinic primary care practice were sent e-mail surveys to understand their perspectives on the implementation and use of pharmacogenomic testing in their clinical practice. Surveys assessed how the clinicians felt about pharmacogenomics and whether they thought electronic PGx-CDS alerts were useful. Information was abstracted on the number of CDS alerts the clinicians received between October 2013 and the date their survey was returned. CDS alerts were grouped into 2 categories: the alert recommended caution using the prescription, or the alert recommended an alternate prescription. Finally, data were abstracted regarding whether the clinician changed their prescription in response to the alert recommendation. Results The survey response rate was 57% (n = 90). Overall, 52% of the clinicians did not expect to use or did not know whether they would use pharmacogenomic information in their future prescribing practices. Additionally, 53% of the clinicians felt that the alerts were confusing, irritating, frustrating, or that it was difficult to find additional information. Finally, only 30% of the clinicians that received a CDS alert changed their prescription to an alternative medication. Conclusions Our results suggest a lack of clinician comfort with integration of pharmacogenomic data into primary care. Further efforts to refine PGx-CDS alerts to make them as useful and user-friendly as possible are needed to improve clinician satisfaction with these new tools.

Original languageEnglish (US)
Pages (from-to)1093-1099.e1
JournalAmerican Journal of Medicine
Volume129
Issue number10
DOIs
StatePublished - Oct 1 2016

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Pharmacogenetics
Prescriptions
Primary Health Care
Clinical Decision Support Systems
Electronic Health Records
Postal Service
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

St. Sauver, J. L., Bielinski, S. J., Olson, J. E., Bell, E. J., Mc Gree, M. E., Jacobson, D. J., ... Rohrer Vitek, C. R. (2016). Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality. American Journal of Medicine, 129(10), 1093-1099.e1. https://doi.org/10.1016/j.amjmed.2016.04.009
St. Sauver, Jennifer L. ; Bielinski, Suzette J. ; Olson, Janet E. ; Bell, Elizabeth J. ; Mc Gree, Michaela E. ; Jacobson, Debra J. ; McCormick, Jennifer B. ; Caraballo, Pedro J. ; Takahashi, Paul Y. ; Roger, Veronique L. ; Rohrer Vitek, Carolyn R. / Integrating Pharmacogenomics into Clinical Practice : Promise vs Reality. In: American Journal of Medicine. 2016 ; Vol. 129, No. 10. pp. 1093-1099.e1.
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abstract = "Background Limited information is available regarding primary care clinicians’ response to pharmacogenomic clinical decision support (PGx-CDS) alerts integrated in the electronic health record. Methods In February 2015, 159 clinicians in the Mayo Clinic primary care practice were sent e-mail surveys to understand their perspectives on the implementation and use of pharmacogenomic testing in their clinical practice. Surveys assessed how the clinicians felt about pharmacogenomics and whether they thought electronic PGx-CDS alerts were useful. Information was abstracted on the number of CDS alerts the clinicians received between October 2013 and the date their survey was returned. CDS alerts were grouped into 2 categories: the alert recommended caution using the prescription, or the alert recommended an alternate prescription. Finally, data were abstracted regarding whether the clinician changed their prescription in response to the alert recommendation. Results The survey response rate was 57{\%} (n = 90). Overall, 52{\%} of the clinicians did not expect to use or did not know whether they would use pharmacogenomic information in their future prescribing practices. Additionally, 53{\%} of the clinicians felt that the alerts were confusing, irritating, frustrating, or that it was difficult to find additional information. Finally, only 30{\%} of the clinicians that received a CDS alert changed their prescription to an alternative medication. Conclusions Our results suggest a lack of clinician comfort with integration of pharmacogenomic data into primary care. Further efforts to refine PGx-CDS alerts to make them as useful and user-friendly as possible are needed to improve clinician satisfaction with these new tools.",
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St. Sauver, JL, Bielinski, SJ, Olson, JE, Bell, EJ, Mc Gree, ME, Jacobson, DJ, McCormick, JB, Caraballo, PJ, Takahashi, PY, Roger, VL & Rohrer Vitek, CR 2016, 'Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality', American Journal of Medicine, vol. 129, no. 10, pp. 1093-1099.e1. https://doi.org/10.1016/j.amjmed.2016.04.009

Integrating Pharmacogenomics into Clinical Practice : Promise vs Reality. / St. Sauver, Jennifer L.; Bielinski, Suzette J.; Olson, Janet E.; Bell, Elizabeth J.; Mc Gree, Michaela E.; Jacobson, Debra J.; McCormick, Jennifer B.; Caraballo, Pedro J.; Takahashi, Paul Y.; Roger, Veronique L.; Rohrer Vitek, Carolyn R.

In: American Journal of Medicine, Vol. 129, No. 10, 01.10.2016, p. 1093-1099.e1.

Research output: Contribution to journalArticle

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AU - St. Sauver, Jennifer L.

AU - Bielinski, Suzette J.

AU - Olson, Janet E.

AU - Bell, Elizabeth J.

AU - Mc Gree, Michaela E.

AU - Jacobson, Debra J.

AU - McCormick, Jennifer B.

AU - Caraballo, Pedro J.

AU - Takahashi, Paul Y.

AU - Roger, Veronique L.

AU - Rohrer Vitek, Carolyn R.

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N2 - Background Limited information is available regarding primary care clinicians’ response to pharmacogenomic clinical decision support (PGx-CDS) alerts integrated in the electronic health record. Methods In February 2015, 159 clinicians in the Mayo Clinic primary care practice were sent e-mail surveys to understand their perspectives on the implementation and use of pharmacogenomic testing in their clinical practice. Surveys assessed how the clinicians felt about pharmacogenomics and whether they thought electronic PGx-CDS alerts were useful. Information was abstracted on the number of CDS alerts the clinicians received between October 2013 and the date their survey was returned. CDS alerts were grouped into 2 categories: the alert recommended caution using the prescription, or the alert recommended an alternate prescription. Finally, data were abstracted regarding whether the clinician changed their prescription in response to the alert recommendation. Results The survey response rate was 57% (n = 90). Overall, 52% of the clinicians did not expect to use or did not know whether they would use pharmacogenomic information in their future prescribing practices. Additionally, 53% of the clinicians felt that the alerts were confusing, irritating, frustrating, or that it was difficult to find additional information. Finally, only 30% of the clinicians that received a CDS alert changed their prescription to an alternative medication. Conclusions Our results suggest a lack of clinician comfort with integration of pharmacogenomic data into primary care. Further efforts to refine PGx-CDS alerts to make them as useful and user-friendly as possible are needed to improve clinician satisfaction with these new tools.

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St. Sauver JL, Bielinski SJ, Olson JE, Bell EJ, Mc Gree ME, Jacobson DJ et al. Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality. American Journal of Medicine. 2016 Oct 1;129(10):1093-1099.e1. https://doi.org/10.1016/j.amjmed.2016.04.009