Pharmacogenomic Testing for Major Depression: A Qualitative Study of the Perceptions of People with Lived Experience and Professional Stakeholders.

Autor:	Slomp C; Department of Psychiatry, University of British Columbia, Vancouver, Canada.; BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada., Morris E; Department of Psychiatry, University of British Columbia, Vancouver, Canada.; BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada., Edwards L; School of Population & Public Health, University of British Columbia, Vancouver, Canada.; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada., Hoens AM; Department of Physical Therapy, University of British Columbia, Vancouver, Canada.; Centre for Health Evaluation and Outcome Sciences, Vancouver, Canada., Landry G; Patient Partner, Vancouver, Canada., Riches L; Patient Partner, Vancouver, Canada., Ridgway L; Patient Partner, Vancouver, Canada., Bryan S; School of Population & Public Health, University of British Columbia, Vancouver, Canada.; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada., Austin J; Department of Psychiatry, University of British Columbia, Vancouver, Canada.; BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada.; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.
Jazyk:	angličtina
Zdroj:	Canadian journal of psychiatry. Revue canadienne de psychiatrie [Can J Psychiatry] 2023 Jun; Vol. 68 (6), pp. 436-452. Date of Electronic Publication: 2022 Nov 28.
DOI:	10.1177/07067437221140383
Abstrakt:	Objectives: With increasing evidence for the clinical utility of pharmacogenomic (PGx) testing for depression, there is a growing need to consider issues related to the clinical implementation of this testing. The perspectives of key stakeholders (both people with lived experience [PWLE] and providers) are critical, but not frequently explored. The purpose of this study was to understand how PWLE and healthcare providers/policy experts (P/HCPs) perceive PGx testing for depression, to inform the consideration of clinical implementation within the healthcare system in British Columbia (BC), Canada. Methods: We recruited two cohorts of participants to complete individual 1-h, semi-structured interviews: (a) PWLE, recruited from patient and research engagement networks and organizations and (b) P/HCPs, recruited via targeted invitation. Interviews were audiotaped, transcribed verbatim, de-identified, and analysed using interpretive description. Results: Seventeen interviews were completed with PWLE (7 with experience of PGx testing for depression; 10 without); 15 interviews were completed with P/HCPs (family physicians, psychiatrists, nurses, pharmacists, genetic counsellors, medical geneticists, lab technologists, program directors, and insurers). Visual models of PWLE's and P/HCP's perceptions of and attitudes towards PGx testing were developed separately, but both were heavily influenced by participants' prior professional and/or personal experiences with depression and/or PGx testing. Both groups expressed a need for evidence and numerous considerations for the implementation of PGx testing in BC, including the requirement for conclusive economic analyses, patient and provider education, technological and clinical support, local testing facilities, and measures to ensure equitable access to testing. Conclusions: While hopeful about the potential for therapeutic benefit from PGx testing, PWLE and P/HCPs see the need for robust evidence of utility, and BC-wide infrastructure and policies to ensure equitable and effective access to PGx testing. Further research into the accessibility, effectiveness, and cost-effectiveness of various implementation strategies is needed to inform PGx testing use in BC.
Databáze:	MEDLINE
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