Pharmacogenetics in primary care: the promise of personalized medicine and the reality of racial profiling.
Pharmacogenetics in primary care: the promise of personalized medicine and the reality of racial profiling.
复制标题
初级保健中的药物遗传学：个性化医疗的前景和种族分析的现实。
DOI：
10.1007/s11013-012-9303-x
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Kreiner,MetaJ
中科院分区：
文献类型：
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作者：
Hunt,LindaM;Kreiner,MetaJ
许多人预计，扩大与疾病风险和药物反应相关的基因变异知识将彻底改变临床医学，使基于基因的个性化医疗成为可能，在这种情况下，医疗保健可以根据他们的基因组扫描为个人量身定制。药物遗传学受到了特别强烈的兴趣，许多药物开发人员热切地致力于确定与药物反应的个体差异相关的遗传变异。虽然新兴遗传知识的临床应用越来越多，但用于药物选择的基因测试尚未广泛使用，许多初级保健临床医生还没有准备好解释遗传信息。我们对58名初级保健临床医生进行了访谈，探讨他们如何将新兴的药物遗传学概念融入他们的实践中。我们发现，在他们目前的实践中，药物遗传学创新并没有导致个性化的治疗，而是鼓励使用本质上的种族/民族身份作为遗传遗传的代表。个性化医疗的当前表现似乎强化了种族群体之间固有的生物学差异的根深蒂固的观念，并促进了一种信念，即医疗保健中的种族定性得到了前沿科学权威的支持。我们的发现引起了人们对药物遗传学创新如何实际影响不同人群的关注，以及如何确保公正的治疗。
Many anticipate that expanding knowledge of genetic variations associated with disease risk and medication response will revolutionize clinical medicine, making possible genetically based Personalized Medicine where health care can be tailored to individuals, based on their genome scans. Pharmacogenetics has received especially strong interest, with many pharmaceutical developers avidly working to identify genetic variations associated with individual differences in drug response. While clinical applications of emerging genetic knowledge are becoming increasingly available, genetic tests for drug selection are not as yet widely accessible, and many primary care clinicians are unprepared to interpret genetic information. We conducted interviews with 58 primary care clinicians, exploring how they integrate emerging pharmacogenetic concepts into their practices. We found that in their current practices, pharmacogenetic innovations have not led to individually tailored treatment, but instead have encouraged use of essentialized racial/ethnic identity as a proxy for genetic heritage. Current manifestations of Personalized Medicine appear to be reinforcing entrenched notions of inherent biological differences between racial groups, and promoting the belief that racial profiling in health care is supported by cutting-edge scientific authority. Our findings raise concern for how pharmacogenetic innovations will actually affect diverse populations, and how unbiased treatment can be assured.