在初级保健机构中实施药物基因组学测试的推动因素和挑战的范围审查
Chun-Wai Mai1, Sathvik B Sridhar2, Mohammed Salim Karattuthodi3
1Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Cheras, Malaysia.
BMJ open
|November 5, 2024
概括
药基因组测试 (PGx) 提高了药物安全性,但在初级保健中面临实施障碍. 应对挑战需要加强患者和提供者教育,并且成本效益的策略对于更广泛的采用至关重要.
科学领域:
- 药物基因组学 药物基因组学
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 药基因组 (PGx) 测试对于提高患者药物安全性至关重要.
- 伦理问题和实际限制阻碍了PGx在初级保健机构的采用.
研究的目的:
- 在初级保健中对PGx实施进行系统审查.
- 确定与PGx在初级保健中的整合相关的推动因素和挑战.
主要方法:
- 根据既定的框架进行全面的范围审查 (阿克西和奥马利,乔安娜·布里格斯研究所,莱瓦克等人. ) 的情况.
- 在2023年7月之前搜索的主要数据库 (Cochrane,EMBASE,全球卫生,MEDLINE,PubMed).
- 包括英语同行评审的关于PGx实施推动因素和初级保健中的挑战的研究.
主要成果:
- 包括78项研究,其中57%自2019年以来发表,主要集中在特定疾病的应用 (68%).
- 关键的推动因素包括诊断/治疗效益和成本降低;挑战包括缺乏证据,培训不足,伦理/法律问题,患者接受度低,成本高.
- 初级保健医生是最多的利益相关者 (55%).
结论:
- 成功的PGx整合需要提高患者意识,并对道德和法律方面进行全面的提供者培训.
- 全球可行性研究是解决实施挑战所必需的.
- 成本管理需要流程简化,报销宣传,以及对创新,负担得起的PGx解决方案的研究.
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