title: Physician Attitudes toward Adopting Genome-Guided Prescribing through Clinical Decision Support.
abstract: This study assessed physician attitudes toward adopting genome-guided prescribing through clinical decision support (CDS), prior to enlisting in the Clinical Implementation of Personalized Medicine through Electronic Health Records and Genomics pilot pharmacogenomics project (CLIPMERGE PGx). We developed a survey instrument that includes the Evidence Based Practice Attitude Scale, adapted to measure attitudes toward adopting genome-informed interventions (EBPAS-GII). The survey also includes items to measure physicians' characteristics (awareness, experience, and perceived usefulness), attitudes about personal genome testing (PGT) services, and comfort using technology. We surveyed 101 General Internal Medicine physicians from the Icahn School of Medicine at Mount Sinai (ISMMS). The majority were residency program trainees (~88%). Prior to enlisting into CLIPMERGE PGx, most physicians were aware of and had used decision support aids. Few physicians, however, were aware of and had used genome-guided prescribing. The majority of physicians viewed decision support aids and genotype data as being useful for making prescribing decisions. Most physicians had not heard of, but were willing to use, PGT services and felt comfortable interpreting PGT results. Most physicians were comfortable with technology. Physicians who perceived genotype data to be useful in making prescribing decisions, had more positive attitudes toward adopting genome-guided prescribing through CDS. Our findings suggest that internal medicine physicians have a deficit in their familiarity and comfort interpreting and using genomic information. This has reinforced the importance of gathering feedback and guidance from our enrolled physicians when designing genome-guided CDS and the importance of prioritizing genomic medicine education at our institutions.
authors.affiliation: Program for Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. coverby@medicine.umaryland.edu.
authors.forename: Casey Lynnette
authors.initials: CL
authors.lastname: Overby
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. stuart.scott@mssm.edu.
authors.forename: Angelika Ludtke
authors.initials: AL
authors.lastname: Erwin
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. stuart.scott@mssm.edu.
authors.forename: Noura S
authors.initials: NS
authors.lastname: Abul-Husn
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. steve.ellis@mountsinai.org.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Ellis
authors.affiliation: Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. stuart.scott@mssm.edu.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Scott
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. joseph.kannry@mountsinai.org.
authors.forename: Aniwaa Owusu
authors.initials: AO
authors.lastname: Obeng
authors.affiliation: Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. joseph.kannry@mountsinai.org.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Kannry
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA. hripcsak@columbia.edu.
authors.forename: George
authors.initials: G
authors.lastname: Hripcsak
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. erwin.bottinger@mssm.edu.
authors.forename: Erwin P
authors.initials: EP
authors.lastname: Bottinger
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. omri.gottesman@mssm.edu.
authors.forename: Omri
authors.initials: O
authors.lastname: Gottesman