Preferences for implementing pharmacogenomics in pediatric primary care: a discrete choice experiment

Pharmacogenomics services are primarily implemented in adult specialty practices, with limited focus on pediatrics, particularly in primary care. This study aimed to assess primary care providers' preferences for implementing pharmacogenomics services in their practice.

A discrete choice experiment using best-worst scaling was designed based on constructs from the Consolidated Framework for Implementation Research (CFIR) domains: Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals, and Process. Questions and scenarios were developed as a survey to primary care providers at a multistate pediatric health system, to evaluate factors influencing pharmacogenomics service integration.

Of 165 providers sent the survey, complete responses were received from 68 (41%). The most important constructs from the five CFIR domains were: Evidence Strength and Quality, Patient Needs and Resources, Access to Knowledge and Information, Knowledge and Beliefs, and Engaging and Champions. Least important constructs from the five domains were: Adaptability, Peer Pressure, Culture and Tension for Change, Individual Identification with Organization, and Opinion Leaders and External Change Agents.

Primary care providers from this pediatric institution identified specific features essential for implementation of a pharmacogenomics service including engaging practitioners/champions, providing education, and establishing access to pharmacogenomic evidence and resources for providers and patients.

Understanding pediatric providers' needs in implementing pharmacogenomics services, including education, resources, and organizational culture, is an underexplored area. The findings support informed strategies to integrate pharmacogenomics into pediatric care, enhancing its adoption into pediatric primary care. This study offers new insights into the pediatric primary care perspective on pharmacogenomics service implementation, highlighting essential priorities such as practitioner champions, targeted education, evidence access, and resource adequacy across a multistate pediatric institution.