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. 2011 Jul 29;1(1):e000110.
doi: 10.1136/bmjopen-2011-000110.

Personalised medicine in Canada: a survey of adoption and practice in oncology, cardiology and family medicine

Katherine Bonter  1 , Clarissa Desjardins, Nathan Currier, Jason Pun, Fredrick D Ashbury
Affiliations

Personalised medicine in Canada: a survey of adoption and practice in oncology, cardiology and family medicine

Katherine Bonter et al. BMJ Open. .

Abstract

Introduction In order to provide baseline data on genetic testing as a key element of personalised medicine (PM), Canadian physicians were surveyed to determine roles, perceptions and experiences in this area. The survey measured attitudes, practice, observed benefits and impacts, and barriers to adoption. Methods A self-administered survey was provided to Canadian oncologists, cardiologists and family physicians and responses were obtained online, by mail or by fax. The survey was designed to be exploratory. Data were compared across specialties and geography. Results The overall response rate was 8.3%. Of the respondents, 43%, 30% and 27% were family physicians, cardiologists and oncologists, respectively. A strong majority of respondents agreed that genetic testing and PM can have a positive impact on their practice; however, only 51% agreed that there is sufficient evidence to order such tests. A low percentage of respondents felt that they were sufficiently informed and confident practicing in this area, although many reported that genetic tests they have ordered have benefited their patients. Half of the respondents agreed that genetic tests that would be useful in their practice are not readily available. A lack of practice guidelines, limited provider knowledge and lack of evidence-based clinical information were cited as the main barriers to practice. Differences across provinces were observed for measures relating to access to testing and the state of practice. Differences across specialties were observed for the state of practice, reported benefits and access to testing. Conclusions Canadian physicians recognise the benefits of genetic testing and PM; however, they lack the education, information and support needed to practice effectively in this area. Variability in practice and access to testing across specialties and across Canada was observed. These results support a need for national strategies and resources to facilitate physician knowledge, training and practice in PM.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Distribution of respondents by specialty: family medicine (Fam.), cardiology (Card.) and oncology (Onco.) and by geography: Ontario (ON), Quebec (QC), British Columbia (BC), Western Provinces (WST) and Atlantic provinces (ALT).
Figure 2
Figure 2
Respondent's perceptions of utility by speciality (panel A): family medicine (Fam.), cardiology (Card.) and oncology (Onco.) and by geography (panel B): Ontario (ON), Quebec (QC), British Columbia (BC), Western provinces (WST) and Atlantic provinces (ALT).
Figure 3
Figure 3
Measures of state of practice by specialty (panel A): family medicine (Fam.), cardiology (Card.) and oncology (Onco.) and by geography (panel B): Ontario (ON), Quebec (QC), British Columbia (BC), Western provinces (WST) and Atlantic provinces (ALT). GT, genetic test; PM, personalised medicine.
Figure 4
Figure 4
Comparison of reported impacts and benefits by specialty (panel A): family medicine (Fam.), cardiology (Card.) and oncology (Onco.) and by geography (panel B): Ontario (ON), Quebec (QC), British Columbia (BC), Western Provinces (WST) and Atlantic provinces (ALT). ID, identified.
Figure 5
Figure 5
Measures of barriers to access by speciality (panel A): family medicine (Fam.), cardiology (Card.) and oncology (Onco.) and by geography (panel B): Ontario (ON), Quebec (QC), British Columbia (BC), Western provinces (WST) and Atlantic provinces (ALT).
Figure 6
Figure 6
Measures of physician education in genetic testing and personalised medicine by speciality.
See this image and copyright information in PMC

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