Understanding clinician support preferences related to the use of pharmacogenomic results in electronic health records: A qualitative study in an academic health system

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association Pub Date : 2025-08-25 DOI:10.1016/j.japh.2025.102912

Erika N. Dreikorn, Seth Sacchi, Katherine Riden, Philip E. Empey, Mylynda B. Massart, Lucas A. Berenbrok

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引用次数: 0

Abstract

Background

Integrating pharmacogenomic (PGx) test results into electronic health records (EHRs) represents a crucial step in the advancement of precision medicine. However, successful implementation is often hindered by lack of, or gaps in, clinician training; lack of clinician confidence; and system-level barriers such as limited awareness of PGx utility, complex interpretation of results, and time constraints.

Objectives

Through qualitative analysis, this study aimed to identify clinician preferences regarding the educational, technical, and workflow supports needed to effectively integrate PGx results into EHRs.

Methods

Clinicians practicing in a large academic health system in Western Pennsylvania, including physicians, advanced practice nurses, physician assistants, and pharmacists, were invited to participate in this study. The research team developed a semi-structured interview guide using the Consolidated Framework for Implementation Research as a framework. Interviews were conducted using videoconferencing software, transcribed, and analyzed using inductive reasoning analysis to identify key barriers and proposed solutions.

Results

Sixteen interviews were conducted, which revealed 7 themes: (1) contextualization of utility; (2) clinician confidence and comfort; (3) consultations; (4) resulting and alerting; (5) communication of pharmacogenomic results; (6) decelerators; and (7) education preferences. Participants emphasized the need for simplified workflows, specialty-specific training, embedded EHR tools, and patient-centered communication strategies.

Conclusion

Clinician-preferred strategies, including intuitive clinical decision support tools, modular education resources, and streamlined communication pathways, are critical to successful PGx implementation. These findings offer a practical blueprint for integrating PGx into clinical practice and inform scalable models for precision medicine adoption across health systems. Further research should explore nuanced themes to further accelerate PGx deployments.

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了解临床医生的偏好以支持电子健康记录中的药物基因组学结果：一项学术卫生系统的定性研究。

背景：将药物基因组学（PGx）检测结果整合到电子健康记录（EHRs）中是推进精准医疗的关键一步。然而，临床医生培训的缺乏或差距往往阻碍了成功的实施；缺乏临床医生的信心；以及系统级别的障碍，例如对PGx效用的有限认识、对结果的复杂解释和时间限制。目的：通过定性分析，本研究旨在确定临床医生对有效地将PGx结果整合到电子病历中所需的教育、技术和工作流程支持的偏好。方法：在宾夕法尼亚州西部的一个大型学术卫生系统中执业的临床医生，包括医生、高级执业护士、医师助理和药剂师，被邀请参加本研究。研究小组以实施研究综合框架（CFIR）为框架，制定了半结构化访谈指南。访谈使用视频会议软件进行，转录和分析使用归纳推理分析，以确定关键障碍和提出的解决方案。结果：共进行了16次访谈，揭示了7个主题：(1)效用情境化；(2)临床医师信心和舒适度；(3)磋商;(4)结果性和警觉性；(5)药物基因组学结果的交流；(6)减速器;(7)教育偏好。与会者强调了简化工作流程、专门培训、嵌入式电子病历工具和以患者为中心的沟通策略的必要性。结论：临床首选的策略，包括直观的CDS工具、模块化的教育资源和简化的沟通途径，是成功实施PGx的关键。这些发现为将PGx整合到临床实践中提供了实用的蓝图，并为整个卫生系统采用精准医学提供了可扩展的模型。进一步的研究应该探索微妙的主题，以进一步加速PGx的部署。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Pharmacists Association 医学-药学

CiteScore

3.30

自引率

14.30%

发文量

336

审稿时长

46 days

期刊介绍： The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.