1. Does the benefit of pharmacogenomic testing outweigh the risk?
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Benefits
“Laying it out there to see if this person has a genetic susceptibility to the medication [in] good or bad ways. It just helps you make a more informed decision.” “We can essentially be better at our jobs.” “…if the medicine is not helping the patient…then it’s at least helpful to go ahead and get the information and then change the medication accordingly.” “It’s [going to] be better for the patient overall.” “…to change what you’re giving [the patient] and…knowing there might be a reason why a [medication] that works for a lot of people doesn’t work in them.” “What works best in a certain population doesn’t work in some populations, like African American [patients].”
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Risks
“…if the results are not accurate for a patient…you are prescribing something you think is going to work but it doesn’t.” “How much research has been done on it, and is it really cost effective?” “I would need to see efficacy and better treatment after. I would need to see better health in patients who have pharmacogenetic testing done.” “We’re like putting a patient in a certain bracket, so it’s kinda labeling them in a certain way. I do not know if it’ll be used against them or for them.” “…I don’t even think…this population has an understanding of what this is required for.” “If [patients] have to pay out-of-pocket, I think that would be a big stop.”
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2. Is pharmacogenomic testing feasible in daily practice?
“It’s like an extra step…from what we generally do.” “It’s not a bad idea to include it in your annual work-up.” “I think it would be awesome to start right away.”
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3. Should FM be the “gate-keeper” to pharmacogenomic testing?
“Primary care…should be trained…because we’re seeing all kinds of patients and we’re the gate-keeper so we should know what’s going on with everything we have.” “We are simultaneous efforts of all the different specialties together.”
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4. What needs to be addressed in FM residency training curriculums for successful implementation of pharmacogenomic services?
“I want a break-up of how this whole process works and…how I’m [going to] change medication.” “I don’t know that much about it. But if I do my research on it I think I’ll feel more comfortable with it.” “If attending [physicians] start using it, then probably that would force me to use it.” “Pharmacists…have the training; I think you need the knowledge of…pharmacy behind you.” “We need more education, more awareness to integrate it into our day to day…we should have more formal didactics.”
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