title: Integrating Pharmacogenomics into Clinical Practice: Promise vs Reality.
abstract: Limited information is available regarding primary care clinicians' response to pharmacogenomic clinical decision support (PGx-CDS) alerts integrated in the electronic health record.
  
  
  
  In February 2015, 159 clinicians in the Mayo Clinic primary care practice were sent e-mail surveys to understand their perspectives on the implementation and use of pharmacogenomic testing in their clinical practice. Surveys assessed how the clinicians felt about pharmacogenomics and whether they thought electronic PGx-CDS alerts were useful. Information was abstracted on the number of CDS alerts the clinicians received between October 2013 and the date their survey was returned. CDS alerts were grouped into 2 categories: the alert recommended caution using the prescription, or the alert recommended an alternate prescription. Finally, data were abstracted regarding whether the clinician changed their prescription in response to the alert recommendation.
  
  
  
  The survey response rate was 57% (n = 90). Overall, 52% of the clinicians did not expect to use or did not know whether they would use pharmacogenomic information in their future prescribing practices. Additionally, 53% of the clinicians felt that the alerts were confusing, irritating, frustrating, or that it was difficult to find additional information. Finally, only 30% of the clinicians that received a CDS alert changed their prescription to an alternative medication.
  
  
  
  Our results suggest a lack of clinician comfort with integration of pharmacogenomic data into primary care. Further efforts to refine PGx-CDS alerts to make them as useful and user-friendly as possible are needed to improve clinician satisfaction with these new tools.
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. Electronic address: StSauver.Jennifer@mayo.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Suzette J
authors.initials: SJ
authors.lastname: Bielinski
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Olson
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Bell
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Michaela E
authors.initials: ME
authors.lastname: Mc Gree
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Jacobson
authors.affiliation: Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McCormick
authors.affiliation: Department of General Internal Medicine, Mayo Clinic, Rochester, Minn.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Caraballo
authors.affiliation: Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minn.
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Takahashi
authors.affiliation: Division of Cardiovascular Diseases, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn.
authors.forename: Veronique L
authors.initials: VL
authors.lastname: Roger
authors.affiliation: Center for Individualized Medicine, Mayo Clinic, Rochester, Minn.
authors.forename: Carolyn R
authors.initials: CR
authors.lastname: Rohrer Vitek
mesh_terms: D001291:Attitude of Health Personnel; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D005820:Genetic Testing; D006801:Humans; D010597:Pharmacogenetics; D000071184:Pharmacogenomic Variants; D058007:Physicians, Primary Care; D011795:Surveys and Questionnaires
keywords: Clinical practice patterns; Genomics; Pharmacogenetics; Practice patterns