title: Patient Perceptions of Care as Influenced by a Large Institutional Pharmacogenomic Implementation Program.
abstract: Despite growing clinical use of genomic information, patient perceptions of genomic-based care are poorly understood. We prospectively studied patient-physician pairs who participated in an institutional pharmacogenomic implementation program. Trust/privacy/empathy/medical decision-making (MDM)/personalized care dimensions were assessed through patient surveys after clinic visits at which physicians had access to preemptive pharmacogenomic results (Likert scale, 1 = minimum/5 = maximum; mean [SD]). From 2012-2015, 1,261 surveys were issued to 507 patients, with 792 (62.8%) returned. Privacy, empathy, MDM, and personalized care scores were significantly higher after visits when physicians considered pharmacogenomic results. Importantly, personalized care scores were significantly higher after physicians used pharmacogenomic information to guide medication changes (4.0 [1.4] vs. 3.0 [1.6]; P < 0.001) compared with prescribing visits without genomic guidance. Multivariable modeling controlling for clinical factors confirmed personalized care scores were more favorable after visits with genomic-influenced prescribing (odds ratio [OR] = 3.26; 95% confidence interval [CI] = (1.31-8.14); P < 0.05). Physicians seem to individualize care when utilizing pharmacogenomic results and this decision-making augmentation is perceived positively by patients.
authors.affiliation: The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: McKillip
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Borden
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: P
authors.initials: P
authors.lastname: Galecki
authors.affiliation: The Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Ham
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: L
authors.initials: L
authors.lastname: Patrick-Miller
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Hall
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: S
authors.initials: S
authors.lastname: Hussain
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Center for Research Informatics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: K
authors.initials: K
authors.lastname: Danahey
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.|MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois, USA.|Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: M
authors.initials: M
authors.lastname: Siegler
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Sorrentino
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Sacro
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Davis
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: D T
authors.initials: DT
authors.lastname: Rubin
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: K
authors.initials: K
authors.lastname: Lipstreuer
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Polonsky
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: R
authors.initials: R
authors.lastname: Nanda
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: Harper
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Koyner
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Burnet
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Stadler
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.|Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ratain
authors.affiliation: The Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: D O
authors.initials: DO
authors.lastname: Meltzer
authors.affiliation: Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.|Department of Medicine, The University of Chicago, Chicago, Illinois, USA.|Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: O'Donnell
mesh_terms: D001294:Attitude to Health; D000066491:Clinical Decision-Making / Q000379:methods*; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics / Q000379:methods*; D000071185:Pharmacogenomic Testing / Q000379:methods*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D057285:Precision Medicine / Q000523:psychology*; D012938:Social Perception; D014481:United States