TY - JOUR
AU - A. Cernat
AU - J. Abelson
AU - Z. Samaan
AU - A. Ramdyal
AU - M. Vanstone
A1 - 
AB - OBJECTIVES: Many patients with major depressive disorder must try multiple antidepressants before they identify a drug that is both effective and tolerable. Pharmacogenomic (PGx) testing may provide clinicians with guidance around medication choice based on a patient's drug response-related genetic variants. However, this technology is not routinely used in clinical care in Canada, and the views of key actors in the implementation process are largely unknown. The objective of this study was to qualitatively elicit the perspectives and attitudes of clinicians, scientists, policy actors and members of industry about PGx testing to guide antidepressant prescribing in primary care via interviews to help inform implementation policies for this technology. DESIGN: We conducted a qualitative description study. Data analysis proceeded in parallel with data collection and consisted of an inductive qualitative content analysis. SETTING: The focus of this study was implementation of PGx testing in primary care in Ontario, Canada. PARTICIPANTS: We conducted semistructured interviews with 28 individuals who had professional experience relevant to the implementation of PGx testing for depression care ('key informants'). Geographical limits for recruitment were applied based on the transferability of key informants' expertise to the Ontario setting; included participants worked in Canada, the USA and Europe. RESULTS: Participants described views about PGx testing relating to benefits and harms of this technology; their interpretation of the evidence base; implementation-oriented considerations and industry involvement. Overall, participants spoke enthusiastically about PGx testing, but emphasised genetic information is only one component of decision-making about medication prescription. Most endorsed implementation in primary care and felt a pre-emptive approach to testing would be ideal. CONCLUSIONS: Key informants consider the use of PGx testing to guide antidepressant prescribing in primary care as having both patient-level and system-level benefits. Concerns raised centred primarily around clinician education and barriers to access. Future research should focus on questions relating to feasibility of system-wide implementation.
AD - Department of Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada acernat@ualberta.ca.; Health Policy PhD Program, Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.; Department of Psychiatry and Behavioural Neurosciences, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.; Department of Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
AN - 40866058
BT - BMJ Open
C5 - Education & Workforce; Opioids & Substance Use
CP - 8
DA - Aug 27
DO - 10.1136/bmjopen-2024-091562
DP - NLM
ET - 20250827
IS - 8
JF - BMJ Open
LA - eng
N2 - OBJECTIVES: Many patients with major depressive disorder must try multiple antidepressants before they identify a drug that is both effective and tolerable. Pharmacogenomic (PGx) testing may provide clinicians with guidance around medication choice based on a patient's drug response-related genetic variants. However, this technology is not routinely used in clinical care in Canada, and the views of key actors in the implementation process are largely unknown. The objective of this study was to qualitatively elicit the perspectives and attitudes of clinicians, scientists, policy actors and members of industry about PGx testing to guide antidepressant prescribing in primary care via interviews to help inform implementation policies for this technology. DESIGN: We conducted a qualitative description study. Data analysis proceeded in parallel with data collection and consisted of an inductive qualitative content analysis. SETTING: The focus of this study was implementation of PGx testing in primary care in Ontario, Canada. PARTICIPANTS: We conducted semistructured interviews with 28 individuals who had professional experience relevant to the implementation of PGx testing for depression care ('key informants'). Geographical limits for recruitment were applied based on the transferability of key informants' expertise to the Ontario setting; included participants worked in Canada, the USA and Europe. RESULTS: Participants described views about PGx testing relating to benefits and harms of this technology; their interpretation of the evidence base; implementation-oriented considerations and industry involvement. Overall, participants spoke enthusiastically about PGx testing, but emphasised genetic information is only one component of decision-making about medication prescription. Most endorsed implementation in primary care and felt a pre-emptive approach to testing would be ideal. CONCLUSIONS: Key informants consider the use of PGx testing to guide antidepressant prescribing in primary care as having both patient-level and system-level benefits. Concerns raised centred primarily around clinician education and barriers to access. Future research should focus on questions relating to feasibility of system-wide implementation.
PY - 2025
SN - 2044-6055
SP - e091562
ST - Key informant perspectives on pharmacogenomic (PGx) testing for antidepressant prescribing in primary care in Ontario, Canada: a qualitative description study
T1 - Key informant perspectives on pharmacogenomic (PGx) testing for antidepressant prescribing in primary care in Ontario, Canada: a qualitative description study
T2 - BMJ Open
TI - Key informant perspectives on pharmacogenomic (PGx) testing for antidepressant prescribing in primary care in Ontario, Canada: a qualitative description study
U1 - Education & Workforce; Opioids & Substance Use
U3 - 10.1136/bmjopen-2024-091562
VL - 15
VO - 2044-6055
Y1 - 2025
ER -