Clinicians’ Perceptions of Pharmacogenomics use in Psychiatry

Chan, Christopher Yi Wen; Chua, Boon Yiang; Subramaniam, Mythily; Suen, Emily Liew Kai; Lee, Jimmy

doi:10.2217/pgs-2016-0164

Cited by 42 publications

(81 citation statements)

References 19 publications

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“…However patients appear to be more willing to pay out-of-pocket if the disease associated with pharmacogenetic testing is high risk and the risk of recurrent acute coronary or cerebrovascular events associated with clopidogrel failures would certainly fall in this category [21]. Our finding that there is a high acceptance rate for the use of pharmacogenetics to guide treatment in patients with cardiovascular disease is consistent with studies conducted in other populations [10,15,19,22,23]. The utilization of precision medicine may improve drug adherence and result in a decrease in the overall cost of healthcare for patients by decreasing the occurrence of clinical events [24,25].…”

Section: Discussionsupporting

confidence: 83%

“…There may also be social barriers towards genetic testing that may need to be taken into account as Asian patients may be apprehensive about the stigmas that are possibly associated with possessing a certain "defective" gene [14]. In our study, consistent with prior studies, female patients had less favorable attitudes towards pharmacogenetic testing and were more concerned about the negative impacts of precision medicine [14][15][16][17][18][19]. Subgroup analysis revealed that these statistically significant differences occurred more frequently in Korean females.…”

Section: Discussionsupporting

confidence: 79%

See 1 more Smart Citation

International survey of patients undergoing percutaneous coronary intervention and their attitudes toward pharmacogenetic testing

Pereira¹,

Bae

et al. 2019

Pharmacogenetics and Genomics

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Objectives-To evaluate perceptions towards pharmacogenetic testing of patients undergoing percutaneous coronary intervention (PCI) who are prescribed dual anti-platelet therapy (DAPT) and whether geographical differences in these perceptions exist. Methods-TAILOR-PCI is the largest genotype-based cardiovascular clinical trial randomizing participants to conventional DAPT or prospective genotyping guided DAPT. Enrolled patients completed surveys prior to and six-months after randomization.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 79%

International survey of patients undergoing percutaneous coronary intervention and their attitudes toward pharmacogenetic testing

Pereira¹,

Bae

et al. 2019

Pharmacogenetics and Genomics

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show abstract

“…In addition, these results are supported by a survey of the public's opinion toward PGx testing, which found that most U.S. adults were interested in PGx testing to assist with drug selection, medication dosing, and prediction of medication side effects [17]. The presence of skepticism pre-testing was similarly found among non-genotyped patients in another study that contrasted the views of patients who had or had not been genotyped [26]. The genotyped cohort reported a better understanding of PGx with greater recep-tiveness to its use by their provider.…”

Section: Discussionmentioning

confidence: 80%

Patients’ Perspectives on Psychiatric Pharmacogenetic Testing

Liko

Lai

Griffin³

et al. 2020

Pharmacopsychiatry

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Introduction There is growing interest to adopt pharmacogenetic (PGx) testing in psychiatric medicine, despite mixed views regarding its clinical utility. Nevertheless, providers are utilizing PGx testing among patients with mental health disorders. This study sought to assess genotyped patients’ perspectives and experiences with psychiatric PGx testing. Methods Individual semi-structured interviews were conducted among patients with depression who had undergone psychiatric PGx testing. The audio-recorded interviews were transcribed and analyzed inductively and deductively for salient themes. Results Twenty patients (100% Caucasian, 60% female, mean age 39±18 years) were interviewed. The majority of the PGx tests were provider-initiated for patients who failed multiple pharmacotherapies (50%) and/or had medication intolerances (45%). Patients’ pre-testing expectations ranged from hopefulness to indifference to skepticism. Their post-testing experiences varied from optimism to disappointment, with the perceived value of the test influenced by the results and cost of the test. Discussion Genotyped patients had mixed perspectives, expectations, and experiences with psychiatric PGx testing. Their perceived value of the test was influenced by the test outcomes and its cost.

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“…A recent study29 surveying psychiatric pharmacists showed only 36% considered themselves knowledgeable in pharmacogenomics, and 80% worked at sites that did not offer the testing due to lack of funding. Another recent study30 was conducted in Singapore, which only routinely tests for HLA-B*1502 prior to carbamazepine initiation. Most responders in this study believe pharmacogenomic testing has potential in clinical practice but cost and lack of clear guidelines were identified as barriers (94.3% and 84.5%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Overview of pharmacogenomic testing in clinical practice

Gross

Daniel

2018

Mental Health Clinician

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Introduction:Pharmacogenomic tests relevant to neuropsychiatric medications have been clinically available for more than a decade, but the utility of regular testing is still unknown. Tests available include both pharmacokinetic and pharmacodynamic targets. The potential practice benefits vary with each target.Methods:A 10-year literature review was completed utilizing the PubMed database to identify articles relating to the specific pharmacogenomic targets discussed. Further article selection was based on author review for clinical utility.Results:The clinical dosing guidance available for neuropsychiatric medications such as selective serotonin reuptake inhibitors and tricyclic antidepressants with varying genotypes is useful and has strong evidence to support testing, but it is limited to mainly pharmacokinetic application. Pharmacodynamic targets are gaining additional evidence with increased research, and although the mechanisms behind the potential interactions are scientifically sound, the bridge to clinical practice application is still lacking.Discussion:Although the benefits of decreasing adverse reactions and improving response time are appealing, clinicians may not utilize pharmacogenomic testing in routine practice due to several barriers. Further clinical guidance and studies are needed to support testing for other neuropsychiatric medications and targets.

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Clinicians’ Perceptions of Pharmacogenomics use in Psychiatry

Abstract: Most clinicians acknowledge the potential of pharmacogenomic testing in clinical practice. However, concerns with regard to its cost-effectiveness and the lack of clear guidelines are possible barriers to its clinical implementation.

Cited by 42 publications

References 19 publications

International survey of patients undergoing percutaneous coronary intervention and their attitudes toward pharmacogenetic testing

International survey of patients undergoing percutaneous coronary intervention and their attitudes toward pharmacogenetic testing

Patients’ Perspectives on Psychiatric Pharmacogenetic Testing

Overview of pharmacogenomic testing in clinical practice

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