Provision of Personalized Genomic Diagnostic Technologies for Breast and Colorectal Cancer: An Analysis of Patient Needs, Expectations and Priorities

Issa, Amalia M.; Hutchinson, Janis Faye; Tufail, Waqas; Fletcher, Erica Hua; Ajike, Roseline; Tenorio, Jose

doi:10.2217/pme.11.39

Cited by 12 publications

(11 citation statements)

References 27 publications

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“…5 Analysis of focus groups and interviews also showed that people generally held positive views of pharmacogenomics. 10,14,[22][23][24][25][26][27] It is important to highlight that, unlike other surveys involving patients suffering from chronic medical conditions, 11,12 patients in our study were not recruited among participants of a larger pharmacogenomic project. Instead, HF and heart transplant patients were identified directly from our institution's clinics and were introduced to pharmacogenomics by an investigator right before completing the questionnaire.…”

Section: Discussionmentioning

confidence: 99%

“…Possible explanations for these intergroup differences include the fact that HF patients were older and more frequently retired and that many patients had already been denied insurance coverage due to their chronic illness. Although the group variable was not independently associated with the common fear of disclosure to unauthorized persons, 6,[10][11][12]14,[20][21][22]25,27,29,35,39,41 healthy volunteers appeared to be more worried about this possible lack of confidentiality. These observations are noteworthy, because healthy individuals such as those interviewed in our survey will most likely be the patients of tomorrow.…”

Section: Discussionmentioning

confidence: 99%

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Opinions, hopes and concerns regarding pharmacogenomics: a comparison of healthy individuals, heart failure patients and heart transplant recipients

et al. 2014

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It is not yet known whether healthy individuals and patients with a chronic disease have similar attitudes towards pharmacogenomics. Thus we conducted a survey of 175 healthy volunteers, 175 heart failure (HF) patients and 100 heart transplant recipients to compare their opinions on this subject. Most participants (>90%) stated that they would accept pharmacogenomic testing and expressed high hopes regarding its potential applications. Overall, interest for pharmacogenomics was shared equally among the three groups. In contrast, after adjusting for age, gender, education and income, healthy individuals were more likely to voice concerns about potential employment (P=0.008 vs HF, odds ratio (OR)=2.93, confidence interval (CI)=1.33-6.47; P=0.010 vs Transplant, OR=2.46, CI=1.24-4.90) and insurance discrimination (P=0.001 vs HF, OR=5.58, CI=2.01-15.48; P<0.001 vs Transplant, OR=4.98, CI=2.03-12.21) and were possibly more worried by confidentiality issues. These findings highlight the need for strict legislation and proper educational strategies directed at the general population to facilitate the clinical implementation of pharmacogenomics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Opinions, hopes and concerns regarding pharmacogenomics: a comparison of healthy individuals, heart failure patients and heart transplant recipients

et al. 2014

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“…A total of nine studies focused on the patient perspective as it relates to PG testing (Table ) . Most studies were performed in the United States (n=6), with the remaining studies conducted by researchers based in Japan, Germany, and Australia.…”

Section: Resultsmentioning

confidence: 99%

Stakeholder Views on Pharmacogenomic Testing

et al. 2013

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Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into clinical practice.

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“…Eliminates toxicities of ineffective treatment "We use it in patients who are metastatic, who the whole goal of therapy is palliative. And for them to get these many side effects with no benefit doesn't make sense" (14). Conserves resources "For us … cost is not an issue.…”

Section: Benefits Of Kras Testing Explanation/quotementioning

confidence: 99%

“…Test outcomes due to use of proper tissue specimen "I don't know if you get the most benefit if it's the primary lesion or if it's a secondary lesion. I don't know if you test if the sample hasif it's a fresh sample or if you can get a block and test it many years later" (14). Test does not predict treatment response "The only thing is that you would rather have a test that tells you which patient responds, not which one doesn't respond.…”

Section: Concerns With Kras Testing Example/quotementioning

confidence: 99%

Oncologists’ attitudes toward KRAS testing: a multisite study

et al. 2013

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Recent discoveries promise increasingly to help oncologists individually tailor anticancer therapy to their patients’ molecular tumor characteristics. One such promising molecular diagnostic is Kirsten ras (KRAS) tumor mutation testing for metastatic colorectal cancer (mCRC) patients. In the current study, we examined how and why physicians adopt KRAS testing and how they subsequently utilize the information when discussing treatment strategies with patients. We conducted 34 semi-structured in-person or telephone interviews with oncologists from seven different health plans. Each interview was audiotaped, transcribed, and coded using qualitative research methods. Information and salient themes relating to the research questions were summarized for each interview. All of the oncologists in this study reported using the KRAS test at the time of the interview. Most appeared to have adopted the test rapidly, within 6 months of the publication of National Clinical Guidelines. Oncologists chose to administer the test at various time points, although the majority ordered the test at the time their patient was diagnosed with mCRC. While oncologists expressed a range of opinions about the KRAS test, there was a general consensus that the test was useful and provided benefits to mCRC patients. The rapid adoption and enthusiasm for KRAS suggests that these types of tests may be filling an important informational need for oncologists when making treatment decisions. Future research should focus on the informational needs of patients around this test and whether patients feel informed or confident with their physicians’ use of these tests to determine treatment access.

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Provision of Personalized Genomic Diagnostic Technologies for Breast and Colorectal Cancer: An Analysis of Patient Needs, Expectations and Priorities

Abstract: This study demonstrates breast and colorectal cancer patients' willingness to adopt and pay for novel genomic diagnostics, as well as identifies several salient factors associated with patient preferences for genomic diagnostics.

Cited by 12 publications

References 27 publications

Opinions, hopes and concerns regarding pharmacogenomics: a comparison of healthy individuals, heart failure patients and heart transplant recipients

Opinions, hopes and concerns regarding pharmacogenomics: a comparison of healthy individuals, heart failure patients and heart transplant recipients

Stakeholder Views on Pharmacogenomic Testing

Oncologists’ attitudes toward KRAS testing: a multisite study

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