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Kidney Week

Abstract: SA-PO611

Clinician Attitudes Toward Implementation of Precision Medicine

Session Information

  • Pharmacology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

  • 1700 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

  • Tripathy, Purnima Rani, indiana university, Indianapolis, Indiana, United States
  • Kannegolla, Karthik, Indiana University, Bloomington, Indiana, United States
  • Moorthi, Ranjani N., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Eadon, Michael T., Indiana University Division of Nephrology, Indianapolis, Indiana, United States
Background

Advancements in understanding the genetic basis of CKD & pharmacogenomic drug dosing are facilitated by the discovery of genetic predictors. We implemented precision medicine testing in our renal clinics to assess CKD progression risk and hypertension drug dosing.

Methods

Physicians on nephrology services (N=42) were surveyed about their knowledge, attitude & willingness to act on genetic testing results. A 26 question survey was graded on a LIKERT scale from “strongly agree” to “strongly disagree.” Respondents were stratified according to knowledge & attitude. Statistics were calculated with a Fisher’s exact test. We hypothesized clinicians who agreed sufficient evidence was available to support implementation would have more positive attitudes & greater willingness to act on genetic data.

Results

Respondents were grouped as those who agreed there is sufficient evidence to implement genetic testing (supporters N=14) & those who disagreed (nonsupporters N=28). Compared to nonsupporters, supporters agreed that: 1) genetic testing helps them better identify etiology of CKD (p=0.05), 2) the presence of 2 APOL1 risk alleles impacts their management of focal segmental glomerulosclerosis (p=0.05), 3) testing could change their choice of antihypertensives (p=0.01) and 4) testing will help to delay the progression of CKD (p=0.006). Most respondents agreed (98%) that a patient's genetic profile can influence their response to antihypertensives.

We assessed the attitude of clinicians toward genetic testing by asking "whether a discussion of genetic test results is too time-consuming for an encounter". Clinicians who agreed (negative attitude N=19) & those who disagreed (positive attitude N=23) showed differences in their willingness to act on genetic data. Those who felt there is sufficient time to discuss results also agreed that genetic testing of CKD patients provides information that changes their dialysis preparation strategies (p=0.02).

Conclusion

Physicians with greater awareness of the evidence supporting implementation of genomic testing appear to be more likely to act on the genomic results.

Funding

  • Clinical Revenue Support