Implementation of the Genomic Prescribing System (GPS) into clinical decision making has proven effective in the outpatient setting, however it has yet to make a significant impact in the inpatient setting. As a result, most inpatient providers are likely unaware of the genetic polymorphisms that may cause varying drug response across their patient population. Improving patient understanding of pharmacogenomic application may encourage patients to engage their physicians in a discussion about their personalized pharmaceutical prescriptions. The patients and their physicians will have the opportunity to decide whether they want to employ the GPS to personalize their medication. Essentially, the magnified effect of educating patients about pharmacogenomic application has the potential to influence patient satisfaction and how often physicians incorporate the GPS into patient prescribing.
Studies suggest African Americans are less likely to discuss genetics with physicians despite being more likely to believe in its importance. Pharmacogenomics might address disparities in shared decision making and genomic literacy given that prescribing necessitates effective patient-provider communication. We hypothesized that educating patients about pharmacogenomic results would increase genomic literacy as a potential step to decrease health disparities.
Between 2012-2017, pharmacogenomic results of outpatients were provided to physicians at clinic visits. Patients were surveyed after visits about personalized care, with responses compared by self-reported race and education. We separately recruited a prospective cohort of hospitalized African American patients, the ACCOuNT Study, to receive teaching about pharmacogenomics and their own pharmacogenomics results via bedside online portal. The primary aim was to measure racial differences in pharmacogenomics knowledge and changes before and after PEPEPP.
After undergoing pharmaogenomic genotyping, African American patients expressed a greater desire for genetically-guided individualized care than white patients, suggesting that pharmacogenomic results were less effectively incorporated into clinic discussions or were less well understood among African American patients. A patient educational intervention that included delivery of results significantly increased knowledge about pharmacogenomic among African Americans.