Exploring Youth-Perceived Barriers and Attitudes Towards the Clinical Use of Pharmacogenetic Testing to Optimise Antidepressant Pharmacotherapy

Bradley Roberts, Zahra Cooper, Georgia Landery, Susanne Stanley, Bernadette T Majda, Khan RL Collins, P Anthony Akkari, Sean D Hood, Jennifer Rodger
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Abstract

The field of pharmacogenetics (PGx) is experiencing significant growth, with increasing evidence to support its application in psychiatric care, suggesting its potential to personalise treatment plans, optimise medication efficacy, and reduce adverse drug reactions. However, the perceived utility and practicability of PGx for psychiatric treatment in youth remains underexplored. This study investigated youth-perceived barriers and attitudes towards the implementation of PGx testing to guide antidepressant treatment in primary care. Semi-structured focus groups and interviews were conducted with 17 participants aged between 18 to 24 years. These sessions were recorded and transcribed before thematic analysis was used to identify collective themes. Three key themes were identified, including attitudes towards the medication prescription process, concerns and attitudes towards PGx testing, and perceived barriers to its clinical implementation. Although PGx testing was positively perceived by most participants, all participants shared concerns about PGx testing. Participants voiced concerns about the financial impact of PGx testing, the potential for treatment delays, and the accuracy of PGx testing in guiding antidepressant treatment. Additionally, participants noted that the low awareness and willingness of general practitioners to incorporate PGx testing into routine practice could hinder successful clinical implementation. Prior to the implementation of PGx testing into Australian primary practices, it is essential to acknowledge patient perspectives and ensure that clinical practices remain patient-focused. This study highlights important considerations for integrating PGx testing into antidepressant pharmacotherapy and emphasizes the need for future research to address and mitigate youth-perceived barriers.
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探索青少年对药物基因检测在临床上用于优化抗抑郁药物治疗的障碍和态度
药物遗传学(PGx)领域正经历着巨大的发展,越来越多的证据支持其在精神科治疗中的应用,这表明它具有个性化治疗方案、优化药物疗效和减少药物不良反应的潜力。然而,PGx 在青少年精神病治疗中的实用性和可操作性仍未得到充分探索。本研究调查了青少年对实施 PGx 检测以指导初级保健中的抗抑郁治疗的障碍和态度。研究人员对 17 名年龄在 18-24 岁之间的参与者进行了半结构化焦点小组讨论和访谈。在进行主题分析以确定集体主题之前,对这些会议进行了记录和转录。确定了三个关键主题,包括对药物处方流程的态度、对 PGx 检验的关注和态度,以及对其临床实施障碍的看法。尽管大多数参与者对 PGx 检验持积极态度,但所有参与者都对 PGx 检验表示担忧。与会者对 PGx 检测的经济影响、治疗延误的可能性以及 PGx 检测在指导抗抑郁治疗方面的准确性表示担忧。此外,与会者还指出,全科医生对将 PGx 检测纳入常规实践的认识和意愿较低,这可能会阻碍临床实践的成功实施。在澳大利亚基层医疗机构实施 PGx 检测之前,必须承认患者的观点,并确保临床实践始终以患者为中心。本研究强调了将PGx检测纳入抗抑郁药物治疗的重要注意事项,并强调了未来研究解决和减轻青少年认知障碍的必要性。
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