Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-18T18:31:01.878Z Has data issue: false hasContentIssue false
  • English
  • Français

ATTITUDES ON WARFARIN PHARMACOGENETIC TESTING IN CHINESE PATIENTS AND PUBLIC

Published online by Cambridge University Press:  27 January 2014

Sze Ling Chan ,
Joshua Jun Wen Low ,
Kee Seng Chia  and
Hwee-Lin Wee
Sze Ling Chan
Affiliation:
Saw Swee Hock School of Public Health, National University of Singapore
Joshua Jun Wen Low
Affiliation:
Department of Pharmacy, National University of Singapore
Kee Seng Chia
Affiliation:
Saw Swee Hock School of Public Health, National University of Singapore; Center for Molecular Epidemiology, National University of Singapore; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet; Genome Institute of Singapore; Yong Loo Lin School of Medicine, National University of Singapore
Hwee-Lin Wee
Affiliation:
Department of Pharmacy, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Genetic factors affecting warfarin maintenance dose have been well established, but patient acceptance is a necessary consideration for the successful clinical implementation of warfarin pharmacogenetic testing (WPGT). In this study, we aimed to determine the attitudes toward WPGT among Singaporean Chinese.

Methods: A total of 194 warfarin patients and 187 members of the public completed a structured survey on paper and the Internet, respectively. Attitudes were expressed as willingness to undergo WPGT (single item with 5-point response) and expectations and concerns about WPGT (two multi-item scales). Relationships between attitudes and socio-demographic and clinical variables were explored using Fisher's exact test, Student's t-test, one-way analysis of variance or Pearson's correlation.

Results: Majority of respondents were willing to or neutral about undergoing WPGT. Both patients and public had relatively high expectations (mean [SD]: 3.77 [0.63], and 3.97 [0.55], respectively) and moderately high concerns (mean [SD]: 3.30 [0.69] and 3.33 [0.68], respectively) about WPGT. Willingness to undergo WPGT was associated with gender, educational status, length of warfarin treatment, and number of chronic diseases among warfarin patients, and with history of adverse drug reactions and number of chronic diseases among the public. Higher expectation of WPGT was associated with higher willingness (p < .001 in both populations), while higher concern was associated with lower willingness to undergo WPGT among the public (p = .004) but not among patients (p = .072).

Conclusion: Patient acceptance is not a major barrier to clinical implementation of WPGT but patient education is necessary and the ethical, social, and legal issues should be addressed.

Keywords

WarfarinPharmacogenetic testingAttitudesAsian
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 1 , January 2014 , pp. 113 - 120
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Chan, SL, Suo, C, Lee, SC, et al. Translational aspects of genetic factors in the prediction of drug response variability: A case study of warfarin pharmacogenomics in a multi-ethnic cohort from Asia. Pharmacogenomics J. 2012;12:312–318.Google Scholar
2. Shaw, PB, Donovan, JL, Tran, MT, et al. Accuracy assessment of pharmacogenetically predictive warfarin dosing algorithms in patients of an academic medical center anticoagulation clinic. J Thromb Thrombolysis. 2010;30:220–225.CrossRefGoogle ScholarPubMed
3. International Warfarin Pharmacogenetics Consortium, Klein, TE, Altman, RB, Eriksson, N, et al. Estimation of the warfarin dose with clinical and pharmacogenetic data. N Engl J Med. 2009;360:753–764.Google ScholarPubMed
4. Takeuchi, F, Kashida, M, Okazaki, O, et al. Evaluation of pharmacogenetic algorithm for warfarin dose requirements in Japanese patients. Circ J. 2010;74:977–982.Google Scholar
5. Iverson Genetic Diagnostics I. Warfarin Adverse Event Reduction For Adults Receiving Genetic Testing at Therapy INitiation (WARFARIN). In: ClinicalTrials.gov [Internet]. Bethesda, MD: National Library of Medicine. 2000. http://www.clinicaltrials.gov/ct2/show/NCT01305148 NLM Identifier: NCT01305148 (Accessed November 7, 2012).Google Scholar
6. Utrecht Institute for Pharmaceutical Sciences. EUropean Pharmacogenetics of AntiCoagulant Therapy - Warfarin (EU-PACT). In: ClinicalTrials.gov [Internet]. Bethesda, MD: National Library of Medicine. 2000. http://www.clinicaltrials.gov/ct2/show/NCT01119300 NLM Identifier: NCT01119300 (Accessed November 7, 2012).Google Scholar
7. Washington University School of Medicine. Genetics Informatics Trial (GIFT) of Warfarin to Prevent DVT. In: ClinicalTrials.gov [Internet]. Bethesda, MD: National Library of Medicine. 2000. http://www.clinicaltrials.gov/ct2/show/NCT01006733 NLM Identifier: NCT01006733 (Accessed November 7, 2012).Google Scholar
8. National Heart, Lung, and Blood Institute (NHLBI). Clarification of Optimal Anticoagulation Through Genetics (COAG). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine. 2000. http://www.clinicaltrials.gov/ct2/show/NCT00839657 NLM Identifier: NCT00839657 (Accessed November 7, 2012).Google Scholar
9. National University Hospital, Singapore. Assessing the clinical benefits of a pharmacogenetics-guided dosing regiment for calculating warfarin maintenance dose. In: ClinicalTrials.gov [Internet]. Bethesda, MD: National Library of Medicine. 2000. http://www.clinicaltrials.gov/ct2/show/NCT00700895 NLM Identifier: NCT00700895 (Accessed November 7, 2012).Google Scholar
10. Rogausch, A, Prause, D, Schallenberg, A, Brockmöller, J, Himmel, W. Patients’ and physicians’ perspectives on pharmacogenetic testing. Pharmacogenomics. 2006;7:49–59.Google Scholar
11. Haddy, CA, Ward, HM, Angley, MT, McKinnon, RA. Consumers’ views of pharmacogenetics–A qualitative study. Res Social Adm Pharm. 2010;6:221–231.Google Scholar
12. Issa, A, Tufail, W, Hutchinson, J, Tenorio, J, Baliga, MP. Assessing patient readiness for the clinical adoption of personalized medicine. Public Health Genomics. 2009;12:163–169.Google Scholar
13. O'Daniel, J, Lucas, J, Deverka, P, et al. Factors influencing uptake of pharmacogenetic testing in a diverse patient population. Public Health Genomics. 2010;13:48–54.Google Scholar
14. Haga, SB, O'Daniel, JM, Tindall, GM, Lipkus, IR, Agans, R. Survey of US public attitudes toward pharmacogenetic testing. Pharmacogenomics J. 2012;12:197–204.Google Scholar
15. Haga, SB, OʼDaniel, JM, Tindall, GM, Lipkus, IR, Agans, R. Public attitudes toward ancillary information revealed by pharmacogenetic testing under limited information conditions. Genet Med. 2011;13:723–728.Google Scholar
16. Robertson, J. Consent and privacy in pharmacogenetic testing. Nat Genet. 2001;28:207–209.Google Scholar
17. Chin, TM, Tan, SH, Lim, SE, et al. Acceptance, motivators, and barriers in attending breast cancer genetic counseling in Asians. Cancer Detect Prev. 2005;29:412–418.Google Scholar
18. Butt, TF, Cox, AR, Lewis, H, Ferner, RE. Patient experiences of serious adverse drug reactions and their attitudes to medicines: A qualitative study of survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK. Drug Saf. 2011;34:319–328.CrossRefGoogle ScholarPubMed
19. Lorimer, S, Cox, A, Langford, NJ. A patient's perspective: The impact of adverse drug reactions on patients and their views on reporting. J Clin Pharm Ther. 2012;37:148–152.Google Scholar
20. Census of Population. 2010 statistical release 1: Demographic characteristics, education, language and religion. 2011 http://www.singstat.gov.sg/publications/publications_and_papers/cop2010/census10_stat_release1.html (assessed April 2013).Google Scholar
Supplementary material: Image

Chan Supplementary Material

Figure 1

Download Chan Supplementary Material(Image)
Image 42.3 KB