Attitudes on warfarin pharmacogenetic testing in Chinese patients and public.
BACKGROUND
Genetic factors affecting warfarin maintenance dose have been well established, but patient acceptance is a necessary consideration for the successful clinical implementation of warfarin pharmacogenetic testing (WPGT). In this study, we aimed to determine the attitudes toward WPGT among Singaporean Chinese.


METHODS
A total of 194 warfarin patients and 187 members of the public completed a structured survey on paper and the Internet, respectively. Attitudes were expressed as willingness to undergo WPGT (single item with 5-point response) and expectations and concerns about WPGT (two multi-item scales). Relationships between attitudes and socio-demographic and clinical variables were explored using Fisher's exact test, Student's t-test, one-way analysis of variance or Pearson's correlation.


RESULTS
Majority of respondents were willing to or neutral about undergoing WPGT. Both patients and public had relatively high expectations (mean [SD]: 3.77 [0.63], and 3.97 [0.55], respectively) and moderately high concerns (mean [SD]: 3.30 [0.69] and 3.33 [0.68], respectively) about WPGT. Willingness to undergo WPGT was associated with gender, educational status, length of warfarin treatment, and number of chronic diseases among warfarin patients, and with history of adverse drug reactions and number of chronic diseases among the public. Higher expectation of WPGT was associated with higher willingness (p < .001 in both populations), while higher concern was associated with lower willingness to undergo WPGT among the public (p = .004) but not among patients (p = .072).


CONCLUSIONS
Patient acceptance is not a major barrier to clinical implementation of WPGT but patient education is necessary and the ethical, social, and legal issues should be addressed.
Saw Swee Hock School of Public Health, National University of Singapore.
Sze Ling
SL
Chan
Department of Pharmacy, National University of Singapore.
Joshua Jun Wen
JJW
Low
Saw Swee Hock School of Public Health, National University of Singapore; Center for Molecular Epidemiology, National University of Singapore; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet; Genome Institute of Singapore; Yong Loo Lin School of Medicine, National University of Singapore.
Kee Seng
KS
Chia
Department of Pharmacy, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital.
Hwee-Lin
HL
Wee
D044466:Asian People / Q000235:genetics*; D001294:Attitude to Health; D005260:Female; D005828:Genetics, Population; D006801:Humans; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics; D011639:Public Opinion; D012846:Singapore; D011795:Surveys and Questionnaires; D014859:Warfarin / Q000494:pharmacology*
D014859:Warfarin