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Clinicians' Perceptions towards Precision Medicine Tools for Cardiovascular Disease Risk Stratification in South
Michelle Kamp1,2, Oliver Pain3, Andrew May2
1Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, Johannesburg 2001, South Africa.
Insights
South African clinicians show positive perceptions of precision medicine for cardiovascular disease risk stratification, despite knowledge gaps. Integrating genetic data into clinical tools is key to improving adoption and confidence in this approach.
Area of Science:
- Genomics and Precision Medicine
- Cardiovascular Disease Epidemiology
- Healthcare Professional Education
Background:
- Cardiovascular diseases (CVDs) are a major health burden in South Africa.
- Current CVD risk stratification methods face challenges in identifying high-risk individuals.
- Precision medicine (PM) offers a potential avenue for improved CVD risk assessment through genetic profiling.
Purpose of the Study:
- To explore South African clinicians' perceptions of precision medicine-based CVD risk stratification.
- To identify factors influencing clinicians' confidence and knowledge regarding PM for CVD.
- To understand barriers and facilitators for PM adoption in the South African public health setting.
Main Methods:
- An electronic survey was administered to 109 practicing clinicians at four teaching hospitals in Johannesburg.
- The survey assessed perceptions, knowledge, confidence, and current use of genetic testing for CVD risk stratification.
- Statistical analysis examined the influence of demographic and professional characteristics on perceptions.
Main Results:
- A significant proportion of clinicians (78%) reported low knowledge of genetics, with formal training being a key determinant of higher scores.
- Despite knowledge limitations, 84% held positive perceptions of PM approaches for CVD risk stratification.
- Confidence in applying PM was higher among clinicians already involved in CVD risk stratification, but cost and access to services were identified as major barriers.
Conclusions:
- Clinicians in South Africa are receptive to precision medicine for CVD risk stratification, even with current knowledge and resource constraints.
- Integrating genetic information into existing clinical tools and enhancing genetics education are crucial steps to boost clinician confidence and PM adoption.
- Investment in South Africa's genomics capacity and addressing the genetics training gap are essential for advancing precision medicine in cardiovascular healthcare.
Abstract:
Cardiovascular diseases (CVDs) are a leading cause of mortality and morbidity in South Africa. Risk stratification is the preferred approach to disease prevention, but identifying patients at high risk for CVD remains challenging. Assessing genetic risk could improve stratification and inform a clinically relevant precision medicine (PM) approach. Clinicians are critical to PM adoption, thus, this study explores practicing clinicians’ perceptions of PM-based CVD risk stratification in South Africa’s public health setting. Practicing clinicians (n = 109) at four teaching hospitals in Johannesburg, South Africa, completed an electronic self-administered survey. The effect of demographic and professional characteristics on PM-based CVD risk stratification perceptions was assessed. Fewer than 25% of respondents used clinical genetic testing, and 14% had formal genetics training. 78% had a low mean knowledge score, with higher scores associated with genetic training (p < 0.0005) and research involvement (p < 0.05). Despite limited knowledge and resources, 84% perceived PM approaches positively. 57% felt confident in applying the PM-based approach, with those already undertaking CVD risk stratification more confident (p < 0.001). High cost and limited access to genetics services are key barriers. Integrating genetic information into established clinical tools will likely increase confidence in using PM approaches. Addressing the genetics training gap and investment into the country’s genomics capacity is needed to advance PM in South Africa.
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