Abstract

Effective doctor–patient communication is critical for disease management, especially when considering genetic information. We studied patient-provider communications after implementing a point-of-care pharmacogenomic results delivery system to understand whether pharmacogenomic results are discussed and whether medication recall is impacted. Outpatients undergoing preemptive pharmacogenomic testing (cases), non-genotyped controls, and study providers were surveyed from October 2012–May 2017. Patient responses were compared between visits where pharmacogenomic results guided prescribing versus visits where pharmacogenomics did not guide prescribing. Provider knowledge of pharmacogenomics, before and during study participation, was also analyzed. Both providers and case patients frequently reported discussions of genetic results after visits where pharmacogenomic information guided prescribing. Importantly, medication changes from visits where pharmacogenomics influenced prescribing were more often recalled than non-pharmacogenomic guided medication changes (OR = 3.3 [1.6–6.7], p = 0.001). Case patients who had separate visits where pharmacogenomics did and did not, respectively, influence prescribing more often remembered medication changes from visits where genomic-based guidance was used (OR = 3.4 [1.2–9.3], p = 0.02). Providers also displayed dramatic increases in personal genomic understanding through program participation (94% felt at least somewhat informed about pharmacogenomics post-participation, compared to 61% at baseline, p = 0.04). Using genomic information during prescribing increases patient-provider communications, patient medication recall, and provider understanding of genomics, important ancillary benefits to clinical use of pharmacogenomics.

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Author information

Author notes

    • Yasmin Sacro

    Present address: University of Colorado/Denver Health, Denver, CO, USA

    • William R. Harper

    Present address: Northwestern University, Chicago, IL, USA

Affiliations

  1. Center for Personalized Therapeutics, The University of Chicago, Chicago, IL, USA

    • Brittany A. Borden
    • , Keith Danahey
    • , Paige Galecki
    • , Mark Siegler
    • , Matthew J. Sorrentino
    • , Yasmin Sacro
    • , Andrew M. Davis
    • , David T. Rubin
    • , Kristen Lipstreuer
    • , Tamar S. Polonsky
    • , Rita Nanda
    • , William R. Harper
    • , Jay L. Koyner
    • , Deborah L. Burnet
    • , Walter M. Stadler
    • , Robert T. Kavitt
    • , Mark J. Ratain
    •  & Peter H. O’Donnell
  2. Department of Health Sciences, The University of Chicago, Chicago, IL, USA

    • Sang Mee Lee
  3. Center for Research Informatics, The University of Chicago, Chicago, IL, USA

    • Keith Danahey
  4. Department of Medicine, The University of Chicago, Chicago, IL, USA

    • Linda Patrick-Miller
    • , Mark Siegler
    • , Matthew J. Sorrentino
    • , Yasmin Sacro
    • , Andrew M. Davis
    • , David T. Rubin
    • , Kristen Lipstreuer
    • , Tamar S. Polonsky
    • , Rita Nanda
    • , William R. Harper
    • , Jay L. Koyner
    • , Deborah L. Burnet
    • , Walter M. Stadler
    • , Robert T. Kavitt
    • , David O. Meltzer
    • , Mark J. Ratain
    •  & Peter H. O’Donnell
  5. MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA

    • Mark Siegler
  6. Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, IL, USA

    • Mark Siegler
    • , Mark J. Ratain
    •  & Peter H. O’Donnell
  7. The Center for Health and the Social Sciences, The University of Chicago, Chicago, IL, USA

    • David O. Meltzer

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Conflict of interest

KD, MJR, and PHO are named as co-inventors on a pending patent application for the Genomic Prescribing System. MJR is a co-inventor holding patents related to pharmacogenetic diagnostics and receives royalties related to UGT1A1 genotyping, although no royalties were received from the genotyping performed in this study. MJR work has been funded by the NIH, The Conquer Cancer Foundation of the American Society for Clinical Oncology, and The William F. O'Connor Foundation. PHO work has been funded by the NIH, The University of Chicago Comprehensive Cancer Center, The University of Chicago Bucksbaum Institute for Clinical Excellence, and the Central Society for Clinical and Translational Research. The remaining authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Peter H. O’Donnell.

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DOI

https://doi.org/10.1038/s41397-019-0076-2