Incorporating direct-to-consumer genomic information into patient care: attitudes and experiences of primary care physicians

Abstract

Aim: Despite predictions of increased clinical applications, little is known about primary care providers' (PCPs') readiness to apply genomics to patient care. The aim was to assess PCPs' current experience with genetic testing, their assessment of the understandability and clinical utility of information in sample direct-to-consumer reports for genomic assessment of disease risk and warfarin dosing and attitudes toward genomic medicine.

Materials & methods: A web-based survey of PCPs who are members of Knowledge Networks' Physician Consulting Network was conducted.

Results: Of the 502 respondents (23.3% response rate), most ordered genetic tests infrequently. When presented with the direct-to-consumer genomic testing reports, most believed the reports were understandable, and would be willing to review results with a patient, and many believed the results would be helpful in patient management.

Conclusion: Despite limited experience with genetic tests, PCPs are open to helping patients understand genomic information. However, additional physician education is needed.

Keywords: genetic testing; genetics; genomics; pharmacogenomics; physician experience; physician readiness.

Figure 1. Scenarios and direct-to-consumer results used in the survey

^†Patient’s percentile: when compared to a sample population, your patient’s SNP-based risk for the condition falls within the given range of percentiles. ^‡Patient’s lifetime risk: your patient’s risk of this condition over the course of their lifetime. ^§Average lifetime risk: the average person’s risk of this condition over the course of their lifetime, depending on gender.

Figure 2. Responses to genetic testing scenarios

From a 5-point Likert scale, ‘agree’ and ‘strongly agree’ responses were combined (n = 502). *p < 0.01; **p < 0.001.