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Zhang L, Zhou S, Allen JD, Wang F, Pittenger AL, Bishop JR. Assessing pharmacogenomic literacy in China through validation of the Chinese version of the Minnesota Assessment of Pharmacogenomic Literacy. Clin Transl Sci 2023; 16:2356-2368. [PMID: 37721333 PMCID: PMC10651651 DOI: 10.1111/cts.13637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023] Open
Abstract
Pharmacogenomics (PGx) implementation into clinical care is rapidly increasing in China. However, the extent to which the public understands PGx testing and important knowledge domains requiring patient education or counseling remains unclear. To address this, we created and validated the Chinese version of the Minnesota Assessment of Pharmacogenomic Literacy (MAPL-CTM ). The MAPL-C was developed by translating the English MAPL to Chinese following cross-cultural translation guidelines. An online survey validated the MAPL-C and assessed Chinese individuals' PGx literacy. Validation analyses were performed and associations of PGx literacy with participants' characteristics were quantified. Of 959 high-quality responses, the majority of respondents were Han Chinese (96.3%), men (54.5%), aged 18-29 years (70.9%), residing in China (97.3%), and had received college or higher education (95.0%). Out of 15 starting items developed to query specific predefined knowledge domains, two uninformative items were excluded, resulting in a 13-item MAPL-C. Chinese participants' MAPL-C performance was best explained by a three-factor model, encompassing PGx concepts and function, testing limitations, and privacy. Higher MAPL-C performance was associated with younger age, higher education, and previous genetic testing experience. Correct response rates for questions related to testing limitations were lower than those in other domains. The creation and validation of the MAPL-C fills a gap in determining PGx knowledge among Chinese speakers, quantifying PGx literacy within a Chinese cohort, and identifying response patterns and knowledge gaps. The MAPL-C can be useful in clinical practice to guide patient counseling, assess PGx education interventions, and quantify PGx knowledge in relation to outcomes in research studies involving Chinese participants.
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Affiliation(s)
- Lusi Zhang
- Department of Experimental and Clinical Pharmacology, College of PharmacyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Shuqin Zhou
- Department of Emergency, Shanghai Tenth People's HospitalTongji UniversityShanghaiChina
| | - Josiah D. Allen
- Department of PharmacySt. Elizabeth HealthcareEdgewoodKentuckyUSA
| | - Fan Wang
- Department of Experimental and Clinical Pharmacology, College of PharmacyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Amy L. Pittenger
- Department of Pharmaceutical Care and Health Systems, College of PharmacyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jeffrey R. Bishop
- Department of Experimental and Clinical Pharmacology, College of PharmacyUniversity of MinnesotaMinneapolisMinnesotaUSA
- Department of Psychiatry and Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
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Doyle TA, Schmidt KK, Halverson CME, Olivera J, Garcia A, Shugg TA, Skaar TC, Schwartz PH. Patient understanding of pharmacogenomic test results in clinical care. PATIENT EDUCATION AND COUNSELING 2023; 115:107904. [PMID: 37531788 PMCID: PMC11058699 DOI: 10.1016/j.pec.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/30/2023] [Accepted: 07/15/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Previous research has not objectively assessed patients' comprehension of their pharmacogenomic test results. In this study we assessed understanding of patients who had undergone cytochrome P450 2C19 (CYP2C19) pharmacogenomic testing. METHODS 31 semi-structured interviews with patients who underwent CYP2C19 testing after cardiac catheterization and had been sent a brochure, letter, and wallet card explaining their results. Answers to Likert and binary questions were summarized with descriptive statistics. Qualitative data were analyzed using a grounded theory approach, with particular focus on categorization. RESULTS No participants knew the name of the gene tested or their metabolizer status. Seven participants (23%) knew whether the testing identified any medications that would have lower effectiveness or increased adverse effects for them at standard doses ("Adequate Understanding"). Four participants (13%) read their results from the letter or wallet card they received but had no independent understanding ("Reliant on Written Materials"). Ten participants remembered receiving the written materials (32%). CONCLUSION A majority of participants who had undergone CYP2C19 PGx testing did not understand their results at even a minimal level and would be unable to communicate them to future providers. PRACTICE IMPLICATIONS Further research is necessary to improve patient understanding of PGx testing and their results, potentially through improving patient-provider communication.
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Affiliation(s)
- Tom A Doyle
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Karen K Schmidt
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Colin M E Halverson
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jesus Olivera
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Abigail Garcia
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tyler A Shugg
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Todd C Skaar
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Peter H Schwartz
- Indiana University Center for Bioethics, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Philosophy, Indiana University-Purdue University, Indianapolis, IN, USA.
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Murry LT, Hillman LA, Allen JD, Bishop JR. Intersection and Considerations for Patient-Centered Care, Patient Experience, and Medication Experience in Pharmacogenomics. PHARMACY 2023; 11:146. [PMID: 37736918 PMCID: PMC10514786 DOI: 10.3390/pharmacy11050146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
As healthcare continues to embrace the concept of person- and patient-centered care, pharmacogenomics, patient experience, and medication experience will continue to play an increasingly important role in care delivery. This review highlights the intersection between these concepts and provides considerations for patient-centered medication and pharmacogenomic experiences. Elements at the patient, provider, and system level can be considered in the discussion, supporting the use of pharmacogenomics, with components of the patient and medication experience contributing to the mitigation of barriers surrounding patient use and the valuation of pharmacogenomic testing.
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Affiliation(s)
- Logan T. Murry
- College of Pharmacy, The University of Iowa, Iowa City, IA 52242, USA
| | - Lisa A. Hillman
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
| | - Josiah D. Allen
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
- Department of Pharmacy, St. Elizabeth Healthcare, Edgewood, KY 41017, USA
| | - Jeffrey R. Bishop
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
- Medical School, The University of Minnesota, Minneapolis, MN 55455, USA
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Public Attitudes toward Pharmacogenomic Testing and Establishing a Statewide Pharmacogenomics Database in the State of Minnesota. J Pers Med 2022; 12:jpm12101615. [PMID: 36294754 PMCID: PMC9604616 DOI: 10.3390/jpm12101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
The clinical adoption and implementation of pharmacogenomics (PGx) beyond academic medical centers remains slow, restricting the general population from benefitting from this important component of personalized medicine. As an initial step in the statewide initiative of PGx implementation in Minnesota, we engaged community members and assessed attitudes towards PGx testing and acceptability of establishing a secure statewide PGx database for clinical and research use among Minnesota residents. Data was collected from 808 adult attendees at the 2021 Minnesota State Fair through an electronic survey. Eighty-four percent of respondents felt comfortable getting a PGx test for clinical care. Most respondents trusted health professionals (78.2%) and researchers (73.0%) to keep their PGx data private. The majority expressed their support and interest in participating in a statewide PGx database for clinical and research use (64–72%). Higher acceptability of the statewide PGx database was associated with younger age, higher education, higher health literacy, having health insurance, and prior genetic testing. The study sample representing Minnesota residents expressed high acceptability of receiving PGx testing and willingness to participate in PGx data sharing for clinical and research use. Community support and engagement are needed to advance PGx implementation and research on the state scale.
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