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Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling

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ABSTRACT

BACKGROUND

Genomic risk profiling involves the analysis of genetic variations linked through statistical associations to a range of disease states. There is considerable controversy as to how, and even whether, to incorporate these tests into routine medical care.

OBJECTIVE

To assess physician attitudes and uptake of genomic risk profiling among an ‘early adopter’ practice group.

DESIGN

We surveyed members of MDVIP, a national group of primary care physicians (PCPs), currently offering genomic risk profiling as part of their practice.

POPULATION

All physicians in the MDVIP network (N = 356)

RESULTS

We obtained a 44% response rate. One third of respondents had ordered a test for themselves and 42% for a patient. The odds of having ordered personal testing were 10.51-fold higher for those who felt well-informed about genomic risk testing (p < 0.0001). Of those who had not ordered a test for themselves, 60% expressed concerns for patients regarding discrimination by life and long-term/disability insurers, 61% about test cost, and 62% about clinical utility. The odds of ordering testing for their patients was 8.29-fold higher among respondents who had ordered testing for themselves (p < 0.0001). Of those who had ordered testing for patients, concerns about insurance coverage (p = 0.014) and uncertain clinical utility (p = 0.034) were associated with a lower relative frequency of intention to order testing again in the future.

CONCLUSIONS

Our findings demonstrate that respondent familiarity was a key predictor of physician ordering behavior and clinical utility was a primary concern for genomic risk profiling. Educational and interpretive support may enhance uptake of genomic risk profiling.

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Acknowledgements

The authors thank Dr. Hunt Willard for his helpful comments on the manuscript and Ms. Genevieve Tindall for her assistance on the project and manuscript. This work was supported in part by The Duke Endowment (Health Care Division) (S.B.H, J.M.O, L.K-J., G.G., A.C.) and National Institute on Drug Abuse (NIDA) Grant P30 DA023026 (M.M.C.). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA.

Conflict of Interest

Duke University has no relationship with MDVIP. The Executive Health program at Duke University Medical Center offers genomic risk assessments to interested patients, including but not limited to tests provided by Navigenics.

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Authors and Affiliations

  1. Duke Institute for Genome Sciences & Policy, Duke University, 304 Research Drive, Box 90141, Durham, NC, 27708, USA

    Susanne B. Haga PhD, Julianne M. O’Daniel MS, Ley A. Killeya-Jones PhD, Geoffrey S. Ginsburg MD, PhD & Alex Cho MD, MBA

  2. Department of Psychology and Neuroscience, Duke University, 304 Research Drive, Box 90141, Durham, NC, 27708, USA

    Madeline M. Carrig PhD

  3. Department of Medicine, Duke University, 304 Research Drive, Box 90141, Durham, NC, 27708, USA

    Lori A. Orlando MD, MHS, Geoffrey S. Ginsburg MD, PhD & Alex Cho MD, MBA

  4. Institute for Genome Sciences & Policy, and Sanford School of Public Policy, Duke University, 304 Research Drive, Box 90141, Durham, NC, 27708, USA

    Susanne B. Haga PhD

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  1. Susanne B. Haga PhD
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  2. Madeline M. Carrig PhD
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  3. Julianne M. O’Daniel MS
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Corresponding author

Correspondence to Susanne B. Haga PhD.

ELECTRONIC SUPPLEMENTARY MATERIAL

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Haga, S.B., Carrig, M.M., O’Daniel, J.M. et al. Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling. J GEN INTERN MED 26, 834–840 (2011). https://doi.org/10.1007/s11606-011-1651-7

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  • DOI: https://doi.org/10.1007/s11606-011-1651-7

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