title: Patient reactions to personalized medicine vignettes: an experimental design.
abstract: OBJECTIVE
  Translational investigation on personalized medicine is in its infancy. Exploratory studies reveal attitudinal barriers to "race-based medicine" and cautious optimism regarding genetically personalized medicine. This study describes patient responses to hypothetical conventional, race-based, or genetically personalized medicine prescriptions.
  
  
  METHODS
  Three hundred eighty-seven participants (mean age = 47 years; 46% white) recruited from a Baltimore outpatient center were randomized to this vignette-based experimental study. They were asked to imagine a doctor diagnosing a condition and prescribing them one of three medications. The outcomes are emotional response to vignette, belief in vignette medication efficacy, experience of respect, trust in the vignette physician, and adherence intention.
  
  
  RESULTS
  Race-based medicine vignettes were appraised more negatively than conventional vignettes across the board (Cohen's d = -0.51-0.57-0.64, P < 0.001). Participants rated genetically personalized comparably with conventional medicine (-0.14-0.15-0.17, P = 0.47), with the exception of reduced adherence intention to genetically personalized medicine (Cohen's d = -0.38-0.41-0.44, P = 0.009). This relative reluctance to take genetically personalized medicine was pronounced for racial minorities (Cohen's d = -0.38-0.31-0.25, P = 0.02) and was related to trust in the vignette physician (change in R = 0.23, P < 0.001).
  
  
  CONCLUSIONS
  This study demonstrates a relative reluctance to embrace personalized medicine technology, especially among racial minorities, and highlights enhancement of adherence through improved doctor- patient relationships.
authors.affiliation: Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21202, USA. mbutrick@jhsph.edu
authors.forename: Morgan
authors.initials: M
authors.lastname: Butrick
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kaphingst
authors.forename: Lori H
authors.initials: LH
authors.lastname: Erby
authors.forename: Carlton
authors.initials: C
authors.lastname: Haywood
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
authors.forename: Howard P
authors.initials: HP
authors.lastname: Levy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010817:Physician-Patient Relations; D057285:Precision Medicine / Q000523:psychology*; D044469:Racial Groups / Q000523:psychology; D012107:Research Design; D035502:Trust / Q000523:psychology