National survey of physicians' perspectives on pharmacogenetic testing in solid organ transplantation
National survey of physicians' perspectives on pharmacogenetic testing in solid organ transplantation
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DOI：
10.1111/ctr.14037
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发表时间：
2020-08-06
影响因子：
2.1
通讯作者：
Aquilante, Christina L.
中科院分区：
文献类型：
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作者：
Deininger, Kimberly M.;Tsunoda, Shirley M.;Aquilante, Christina L.
导言我们的目标是评估医生对肾、肝、心和肺移植(KLHL-TX)药物遗传学(PGx)测试的临床实用性的看法。方法对美国KLHL-TX中心的内科和外科主任进行基于网络的36个问题的调查。结果调查对象82人，应答率为10%。大多数是男性(78%)、非西班牙裔白人(70%)、医务主任(72%)和肾移植医生(35%)。尽管78%的受访者报告说他们接受过PGx教育，但大多数人表示对他们的PGx知识和应用PGx测试的能力缺乏信心。参与者报告了对PGx检测的临床效用的不同看法-大多数人同意PGx检测的有效性，但不同意相对于风险或护理标准的好处。尽管55%的人报告他们的机构可以进行测试，但在过去的一年里，只有38%的人订购了PGx测试，最常见的是硫嘌呤-S-甲基转移酶。医生报告的实施PGx的障碍包括对PGx测试的临床价值的不确定性和患者的经济负担。结论：我们的研究结果表明，需要进行前瞻性的PGx研究和中试实施计划，以阐明PGx在KLHL-TX中的临床应用和价值。这些举措应包括宣传使用PGx检测的教育工作。
Introduction Our objective was to evaluate physicians' perspectives on the clinical utility of pharmacogenetic (PGx) testing in kidney, liver, heart, and lung transplantation (KLHL-Tx). Methods A 36-question web-based survey was developed and administered to medical and surgical directors of US KLHL-Tx centers. Results There were 82 respondents (10% response rate). The majority were men (78%), non-Hispanic whites (70%), medical directors (72%), and kidney transplant physicians (35%). Although 78% of respondents reported having some PGx education, most reported lack of confidence in their PGx knowledge and ability to apply a PGx test. Participants reported mixed views about the clinical utility of PGx testing-most agreed with the efficacy of PGx testing, but not the benefits relative to the risks or standard of care. While 55% reported that testing was available at their institution, only 38% ordered a PGx test in the past year, most commonly thiopurine-S-methyltransferase. Physician-reported barriers to PGx implementation included uncertainty about the clinical value of PGx testing and patient financial burden. Conclusion Together, our findings suggest prospective PGx research and pilot implementation programs are needed to elucidate the clinical utility and value of PGx in KLHL-Tx. These initiatives should include educational efforts to inform the use of PGx testing.