Patient Perceptions of Care as Influenced by a Large Institutional Pharmacogenomic Implementation Program.

Area of Science:

• Genomic Medicine
• Patient-Centered Care
• Clinical Implementation Science

Background:

• Growing clinical integration of genomic information necessitates understanding patient perspectives.
• Limited data exists on how patients perceive genomic-based healthcare interventions.
• Pharmacogenomics (PGx) offers potential for personalized medicine but requires patient acceptance.

Purpose of the Study:

• To assess patient perceptions of care dimensions (trust, privacy, empathy, medical decision-making [MDM], personalized care) during pharmacogenomic implementation.
• To evaluate how physician use of preemptive pharmacogenomic results influences patient-reported outcomes.
• To understand the impact of genomic-guided medication changes on patient experience.

Main Methods:

• Prospective study of patient-physician pairs in an institutional pharmacogenomic program (2012-2015).
• Patient surveys assessed perceptions of care dimensions using a 5-point Likert scale post-visit.
• Statistical analysis, including multivariable modeling, compared perceptions based on physician use of pharmacogenomic data.

Main Results:

• Surveys from 792 patients (62.8% return rate) indicated significantly higher scores for privacy, empathy, MDM, and personalized care when physicians considered PGx results.
• Personalized care scores were markedly higher when PGx information guided medication changes (4.0 vs. 3.0; P < 0.001).
• Genomic-influenced prescribing was independently associated with more favorable personalized care scores (OR = 3.26; P < 0.05).

Conclusions:

• Physicians appear to individualize patient care when utilizing pharmacogenomic information.
• Augmenting clinical decision-making with genomic data is positively perceived by patients.
• Pharmacogenomic implementation can enhance patient-reported satisfaction and the perception of personalized care.