Perception of personalized medicine, pharmacogenomics, and genetic testing among undergraduates in Hong Kong

Abstract

Background The global development and advancement of genomic medicine in the recent decade has accelerated the implementation of personalized medicine (PM) and pharmacogenomics (PGx) into clinical practice, while catalyzing the emergence of genetic testing (GT) with relevant ethical, legal, and social implications (ELSI). Results The perception of university undergraduates with regards to PM and PGx was investigated, and 80% of undergraduates valued PM as a promising healthcare model with 66% indicating awareness of personal genome testing companies. When asked about the curriculum design towards PM and PGx, compared to undergraduates in non-medically related curriculum, those studying in medically related curriculum had an adjusted 7.2 odds of perceiving that their curriculum was well-designed for learning PGx (95% CI 3.6–14.6) and a 3.7 odds of perceiving that PGx was important in their study (95% CI 2.0–6.8). Despite this, only 16% of medically related curriculum undergraduates would consider embarking on future education on PM. When asked about their perceptions on GT, 60% rated their genetic knowledge as “School Biology” level or below while 76% would consider undergoing a genetic test. As for ELSI, 75% of undergraduates perceived that they were aware of ethical issues of GT in general, particularly on “Patient Privacy” (80%) and “Data Confidentiality” (68%). Undergraduates were also asked about their perceived reaction upon receiving an unfavorable result from GT, and over half of the participants perceived that they would feel “helpless or pessimistic” (56%), “inadequate or different” (59%), and “disadvantaged at job seeking” (59%), while older undergraduates had an adjusted 2.0 odds of holding the latter opinion (95% CI 1.1–3.5), compared to younger undergraduates. Conclusion Hong Kong undergraduates showed a high awareness of PM but insufficient genetic knowledge and low interest in pursuing a career towards PM. They were generally aware of ethical issues of GT and especially concerned about patient privacy and data confidentiality. There was a predominance of pessimistic views towards unfavorable testing results. This study calls for the attention to evaluate education and talent development on genomics, and update existing legal frameworks on genetic testing in Hong Kong.

Examining key factors impact on health science students’ intentions to adopt genetic and pharmacogenomics testing: a comparative path analysis in two different healthcare settings

“…Malay students were shown to be extremely worried about it along with the existence of phenomena of racial and religious discrimination and privacy deprivation. Cheung et al [ 32 ] stated that the majority of undergraduate students believed that the biggest threats of genetic testing, implementation were “Patient Privacy” (80%) and “Data Confidentiality” (68%), supporting our findings. In general, many studies have pointed out similar conclusions especially in terms of religiosity and religious restrictions [ 33 , 34 ].…”

Awareness, understanding, and interest in personalized medicine: A cross-sectional survey study of college students

“…Most of them never received personal genetic sequencing. The result was consistent with a recent survey conducted in Hong Kong that undergraduates showed a high awareness of PM but insufficient genetic-related knowledge [23].…”

Rare disease emerging as a global public health priority

“…In order to enhance understanding and mitigate genetic discrimination, unprecedented global coalition is of paramount importance to improve inclusivity of the RD population. Previous studies have demonstrated participants' concerns on genetic discrimination in the context of employment and insurance ( 140 – 142 ). In particular, undergraduates in Hong Kong were found to be pessimistic toward unfavorable genetic testing results, with almost 60% of the respondents claiming that they would feel “inadequate or different,” 56% would feel helpless, and nearly 60% perceived that they would be disadvantaged in job seeking in case of unfavorable genetic testing results ( 140 ).…”

“…Previous studies have demonstrated participants' concerns on genetic discrimination in the context of employment and insurance ( 140 – 142 ). In particular, undergraduates in Hong Kong were found to be pessimistic toward unfavorable genetic testing results, with almost 60% of the respondents claiming that they would feel “inadequate or different,” 56% would feel helpless, and nearly 60% perceived that they would be disadvantaged in job seeking in case of unfavorable genetic testing results ( 140 ). It is of utmost importance to eliminate the root causes of stigmatization and discrimination of the RD population in order to improve social inclusion and reduce opportunities and productivity loss.…”