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Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners

Use of pharmacogenetics (PGx) testing to guide clinical decisions is growing in developed countries. Published guidelines for gene–drug pair analysis are available for prescriptions in psychiatry, but information on their utilization, barriers, and health outcomes in Latin America is limited. As a r...

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Autores principales: Undurraga, Juan, Bórquez-Infante, Ignacio, Crossley, Nicolás A., Prieto, Miguel L., Repetto, Gabriela M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082421/
https://www.ncbi.nlm.nih.gov/pubmed/33935777
http://dx.doi.org/10.3389/fphar.2021.657985
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author Undurraga, Juan
Bórquez-Infante, Ignacio
Crossley, Nicolás A.
Prieto, Miguel L.
Repetto, Gabriela M.
author_facet Undurraga, Juan
Bórquez-Infante, Ignacio
Crossley, Nicolás A.
Prieto, Miguel L.
Repetto, Gabriela M.
author_sort Undurraga, Juan
collection PubMed
description Use of pharmacogenetics (PGx) testing to guide clinical decisions is growing in developed countries. Published guidelines for gene–drug pair analysis are available for prescriptions in psychiatry, but information on their utilization, barriers, and health outcomes in Latin America is limited. As a result, this work aimed at exploring current use, opinions, and perceived obstacles on PGx testing among psychiatrists in Chile, via an online, anonymous survey. Among 123 respondents (5.9% of registered psychiatrists in the country), 16.3% reported ever requesting a PGx test. The vast majority (95%) of tests were ordered by clinicians practicing in the Metropolitan Region of Santiago. Having more than 20 years in practice was positively associated with prior use of PGx (p 0.02, OR 3.74 (1.19–11.80)), while working in the public health system was negatively associated (OR 0.30 (0.10–0.83)). Perceived barriers to local implementation included insufficient evidence of clinical utility, limited clinicians’ knowledge on PGx and on test availability, and health systems’ issues, such as costs and reimbursement. Despite the recognition of these barriers, 80% of respondents asserted that it is likely that they will incorporate PGx tests in their practice in the next five years. Given these results, we propose next steps to facilitate implementation such as further research in health outcomes and clinical utility of known and novel clinically actionable variants, growth in local sequencing capabilities, education of clinicians, incorporation of clinical decision support tools, and economic evaluations, all in local context.
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spelling pubmed-80824212021-04-30 Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners Undurraga, Juan Bórquez-Infante, Ignacio Crossley, Nicolás A. Prieto, Miguel L. Repetto, Gabriela M. Front Pharmacol Pharmacology Use of pharmacogenetics (PGx) testing to guide clinical decisions is growing in developed countries. Published guidelines for gene–drug pair analysis are available for prescriptions in psychiatry, but information on their utilization, barriers, and health outcomes in Latin America is limited. As a result, this work aimed at exploring current use, opinions, and perceived obstacles on PGx testing among psychiatrists in Chile, via an online, anonymous survey. Among 123 respondents (5.9% of registered psychiatrists in the country), 16.3% reported ever requesting a PGx test. The vast majority (95%) of tests were ordered by clinicians practicing in the Metropolitan Region of Santiago. Having more than 20 years in practice was positively associated with prior use of PGx (p 0.02, OR 3.74 (1.19–11.80)), while working in the public health system was negatively associated (OR 0.30 (0.10–0.83)). Perceived barriers to local implementation included insufficient evidence of clinical utility, limited clinicians’ knowledge on PGx and on test availability, and health systems’ issues, such as costs and reimbursement. Despite the recognition of these barriers, 80% of respondents asserted that it is likely that they will incorporate PGx tests in their practice in the next five years. Given these results, we propose next steps to facilitate implementation such as further research in health outcomes and clinical utility of known and novel clinically actionable variants, growth in local sequencing capabilities, education of clinicians, incorporation of clinical decision support tools, and economic evaluations, all in local context. Frontiers Media S.A. 2021-04-15 /pmc/articles/PMC8082421/ /pubmed/33935777 http://dx.doi.org/10.3389/fphar.2021.657985 Text en Copyright © 2021 Undurraga, Bórquez-Infante, Crossley, Prieto and Repetto. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Undurraga, Juan
Bórquez-Infante, Ignacio
Crossley, Nicolás A.
Prieto, Miguel L.
Repetto, Gabriela M.
Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title_full Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title_fullStr Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title_full_unstemmed Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title_short Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners
title_sort pharmacogenetics in psychiatry: perceived value and opinions in a chilean sample of practitioners
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082421/
https://www.ncbi.nlm.nih.gov/pubmed/33935777
http://dx.doi.org/10.3389/fphar.2021.657985
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