Implementing pharmacogenetic testing in rural primary care practices: a pilot feasibility study

Assess feasibility and perspectives of pharmacogenetic testing/PGx in rural, primary care physician (PCP) practices when PCPs are trained to interpret/apply results and testing costs are covered. Participants included PCPs who agreed to training, surveys and interviews and eligible patients who agreed to surveys and testing. 51 patients from three practices participated. Prestudy, no PCP had ever ordered a PGx test. Test results demonstrated gene variations in 30% of patients, related to current medications, with PCPs reporting changes to drug management. Poststudy, test cost was still a concern, but now PCPs reported practical barriers, including the utilization of PGx results over time. PCPs and patients had favorable responses to testing. PGx testing is feasible in rural PCP practices. Although genetic tests exist to predict response to drug therapy for commonly used drugs, test use among primary care physicians is low. Three commonly reported barriers to use of these tests include physicians not being well educated about these tests, physicians not being comfortable interpreting and applying test results and concern over cost of testing. This pilot feasibility study assessed physician and patient perspectives when these three barriers were addressed. Surveys demonstrated satisfaction with the testing experience. Results indicate 30% of patients had a genetic variation potentially affecting a currently used drug. Genetic testing is feasible in primary care.