Physicians’ pharmacogenomics information needs and seeking behavior: a study with case vignettes

Abstract

BackgroundGenetic testing, especially in pharmacogenomics, can have a major impact on patient care. However, most physicians do not feel that they have sufficient knowledge to apply pharmacogenomics to patient care. Online information resources can help address this gap. We investigated physicians’ pharmacogenomics information needs and information-seeking behavior, in order to guide the design of pharmacogenomics information resources that effectively meet clinical information needs.MethodsWe performed a formative, mixed-method assessment of physicians’ information-seeking process in three pharmacogenomics case vignettes. Interactions of 6 physicians’ with online pharmacogenomics resources were recorded, transcribed, and analyzed for prominent themes. Quantitative data included information-seeking duration, page navigations, and number of searches entered.ResultsWe found that participants searched an average of 8 min per case vignette, spent less than 30 s reviewing specific content, and rarely refined search terms. Participants’ information needs included a need for clinically meaningful descriptions of test interpretations, a molecular basis for the clinical effect of drug variation, information on the logistics of carrying out a genetic test (including questions related to cost, availability, test turn-around time, insurance coverage, and accessibility of expert support).Also, participants sought alternative therapies that would not require genetic testing.ConclusionThis study of pharmacogenomics information-seeking behavior indicates that content to support their information needs is dispersed and hard to find. Our results reveal a set of themes that information resources can use to help physicians find and apply pharmacogenomics information to the care of their patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-017-0510-9) contains supplementary material, which is available to authorized users.

Patient Characteristics, Experiences and Perceived Value of Pharmacogenetic Testing from a Single Testing Laboratory

“…However, even if information about PGx testing is found, it may not be comprehensive, accurate or understandable to patients. Providers have also reported struggling to find information online about PGx testing to inform appropriate use [14,15]. Patients with low health literacy may have additional challenges with comprehending information about PGx testing or be less likely to seek health information [16].…”

Personal, technical and organisational factors affect whether physicians seek answers to clinical questions during patient care: a literature review

“…Other mentioned themes ( n = 4) were ‘increased awareness of resources by training’ (Almazrou et al, 2019; Bellman et al, 2005; Bernard et al, 2012; Heponiemi et al, 2019). Other facilitators ( n = 3) were ‘navigation support’ (Bernard et al, 2012; Heale et al, 2017; Rahmner et al, 2012), ‘more relevant and reliable information for clinical practice’ (Bellman et al, 2005; Bernard et al, 2012; Sarbaz et al, 2018), ‘reduced Financial cost’ (Bernard et al, 2012; Sarbaz et al, 2018; Shabi et al, 2011) and ‘smart features linked to the HER’ (Cook et al, 2018; King et al, 2019; Rahmner et al, 2012). Reoccurring themes (factors) include ‘summarised and analysed evidence‐based materials’ (Bernard et al, 2012; Shabi et al, 2011), ‘ready access to electronic resources’ (Cook et al, 2013; Heale et al, 2017), ‘utilisation of Internet and information searching skills’ (Norbert & Lwoga, 2013; Shabi et al, 2011), ‘knowing preferred sites or textbooks’ (Bennett et al, 2006; Norbert & Lwoga, 2013), ‘being in the teaching environment’ (Bellman et al, 2005; Kahouei, Alaei, Panahi, & Zadeh, 2015).…”

“…Having the ability to access clinical information for decision‐making about patient care is essential for physicians (Sarbaz, Kimiafar, & Yazdipour, 2017). In such case, accurate, available (Norbert & Lwoga, 2013), reliable (Callen, Buyankhishig, & McIntosh, 2008; Kazempour & Ashrafi‐rizi, 2018), best evidence (Bernard, Arnould, Saint‐Lary, Duhot, & Hebbrecht, 2012) and up‐to‐date (Gonzalez‐Gonzalez et al, 2007; Kazempour & Ashrafi‐rizi, 2018) clinical information will decrease referral rate, improves diagnostic accuracy, increases treatment efficiency (Cook, Sorensen, Wilkinson, & Berger, 2013), reduces medical errors (Brown, Borowitz, & Novicoff, 2004; Flynn & McGuinness, 2011; Norbert & Lwoga, 2013), increases patients' satisfaction of health care (Davies, 2011; Heale, Khalifa, Stone, Nelson, & Del Fiol, 2017; Norbert & Lwoga, 2013), results in high‐quality medical services and solves various health questions (Norbert & Lwoga, 2013).…”

<p>Pharmacogenomic Testing In Pediatrics: Navigating The Ethical, Social, And Legal Challenges</p>

“…While some literature indicates inclusion of precision medicine and PGx in medical curricula,151–153 it is unclear how consistent or to what depth this subject is taught. In some cases, patients may share PGx results ordered by specialists with their general pediatrician, who may not be prepared to integrate the findings into practice, and online resources about PGx are not easily located through search queries 154. Thus, to address knowledge gaps and acknowledge varied learning styles, multiple modes of information delivery are likely needed to increase providers’ knowledge and comfort in delivering PGx testing, such as immersive learning opportunities and traditional continuing medical education (e.g., workshops, online modules, print) 155,156…”