TY - JOUR
T1 - Pharmacogenetics in Psychiatry
T2 - Perceived Value and Opinions in a Chilean Sample of Practitioners
AU - Undurraga, Juan
AU - Bórquez-Infante, Ignacio
AU - Crossley, Nicolás A.
AU - Prieto, Miguel L.
AU - Repetto, Gabriela M.
N1 - Funding Information:
Supported in part by ANID-PIA-ACT192064 (JU, NC, GMR), FONDECYT 1180358 (JU), 1200601 (NAC), 1171014 (GMR), 1181365 (MLP), FONDEF ID19I10116 (MLP) and Clínica Alemana de Santiago ID 863 (JU). Funding for researchers’ time. and publication fees The agencies had no role in study design, analysis, interpretation of results, or manuscript writing.
Publisher Copyright:
© Copyright © 2021 Undurraga, Bórquez-Infante, Crossley, Prieto and Repetto.
PY - 2021/4/15
Y1 - 2021/4/15
N2 - 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.
AB - 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.
KW - Chile
KW - implementation
KW - Latin America
KW - pharmacogenetics
KW - psychiatry
UR - http://www.scopus.com/inward/record.url?scp=85104958889&partnerID=8YFLogxK
U2 - 10.3389/fphar.2021.657985
DO - 10.3389/fphar.2021.657985
M3 - Article
AN - SCOPUS:85104958889
SN - 1663-9812
VL - 12
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
M1 - 657985
ER -
