General practitioners’ (GPs) experience, attitudes and needs on clinical genetic services: a systematic review

Abstract

ObjectiveThe proliferation and growing demands of genetic testing are anticipated to revolutionise medical practice. As gatekeepers of healthcare systems, general practitioners (GPs) are expected to play a critical role in the provision of clinical genetic services. This paper aims to review existing literature on GPs’ experience, attitudes and needs towards clinical genetic services.DesignA systematic mixed studies review of papers published between 2010 and 2022.Eligibility criteriaThe inclusion criterion was peer-reviewed articles in English and related to GPs’ experience, views and needs on any genetic testing.Information sourcesThe PubMed, PsycINFO, Cochrane, EMBASE databases were searched using Mesh terms, Boolean and wildcards combinations to identify peer-reviewed articles published from 2010 to 2022. Study quality was assessed using Mixed Methods Appraisal Tool. Only articles that fulfilled the inclusion criteria were selected. A thematic meta-synthesis was conducted on the final sample of selected articles to identify key themes.ResultsA total of 62 articles were included in the review. Uncertainty over GPs’ role in providing genetic services were attributed by the lack of confidence and time constraints and rarity of cases may further exacerbate their reluctance to shoulder an expanded role in clinical genetics. Although educational interventions were found to increasing GPs’ knowledge and confidence to carry out genetic tasks, varied interest on genetic testing and preference for a shared care model with other genetic health professionals have resulted in minimal translation to clinical adoption.ConclusionThis review highlights the need for deeper exploration of GPs’ varied experience and attitudes towards clinical genetic services to better facilitate targeted intervention in the adoption of clinical genetics.

Navigating genomic testing: Evaluation of an e-learning module with general practitioners

“…Our assessment of behavioural change was halted by low GP recruitment for the interview 6 months after completion of the module. This may have been due to busy GPs' perceived lack of time to schedule and complete an interview rather than a survey (Brodaty et al, 2013), a lack of perceived value in participating further in research without additional professional development (Brodaty et al, 2013) or a rarity of genetic cases to practise what they had learnt between surveys and interview (Ong et al, 2022). Evidence for improved clinical practice after a medical genomics education intervention is scant in the literature (Paneque et al, 2016;Talwar et al, 2017).…”

“…However, future research may benefit from the new roles for Australian GPs in genetic carrier screening (Delatycki et al, 2019), providing additional incentive for GPs to undertake genomics education and participate in its evaluation. Longer-term research with GPs may also be facilitated through additional communication and/or offering additional education updates as part of any follow-up (Ong et al, 2022) to increase the perceived value of the GPs' participation.…”

“…To effectively integrate genomics and precision medicine into routine healthcare in Australia, upskilling the non-genetics workforce is a priority (O'Shea et al, 2022). However, web-based interventions may bridge knowledge gaps but rarely translate into behaviour change (Ong et al, 2022) without additional workplace learning, access to communities of practice (Reed et al, 2016) or multidisciplinary team models. These findings are reported in accordance with the Rise2 Genomics reporting standards for genomics education and evaluation (Nisselle et al, 2021) to contribute to evidence for effective genomics education across different specialties, contexts and modalities.…”

Utility of pharmacogenetic testing to optimise antidepressant pharmacotherapy in youth: a narrative literature review

“…Having a comprehensive knowledge of common psychiatric drugs is paramount when properly interpreting PGx testing information to ensure patient safety and avoid ADRs from drug-drug interactions. A recent review by Ong et al (2022) investigated the experience, attitudes, and knowledge of GPs towards the application of PGx in primary practice and found that whilst most GPs understood the basic principles and recognised the potential benefits of using PGx testing, many were uncertain about how to use genetic testing to inform treatment decisions. This was further supported in recent findings, where the implementation of PGx education and training efforts were shown to improve the comfort felt by primary care providers, such as GPs, when ordering a PGx test for their patients ( Preys et al, 2023 ).…”

“…Although the studies above illustrate a keen understanding on the usefulness for PGx testing in the primary care setting, with no endorsed guidelines on the use of PGx testing in clinical practice, many GPs have expressed the need for further research that explores the translation of new genetic technologies into clinical practice to help inform the development of such guidelines. The review by Ong et al (2022) emphasised the importance of gathering a complete understanding of the experiences, knowledge, and attitudes held by GPs towards genetic testing. Gathering this information and tailoring the integration of PGx testing to the requirements of primary care providers is integral for successful adoption into clinical practice ( Aboelbaha et al, 2023 ).…”