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Personalised medicine in Canada: a survey of adoption and practice in oncology, cardiology and family medicine

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Bonter, Katherine, Desjardins, Clarissa, Currier, Nathan, Pun, Jason, Ashbury, Fredrick D·2011·BMJ Open
DOI 10.1136/bmjopen-2011-000110PMC PMC3191410
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Abstract

Introduction: In order to provide baseline data on genetic testing as a key element of personalised medicine (PM), Canadian physicians were surveyed to determine roles, perceptions and experiences in this area. The survey measured attitudes, practice, observed benefits and impacts, and barriers to adoption. Methods: A self-administered survey was provided to Canadian oncologists, cardiologists and family physicians and responses were obtained online, by mail or by fax. The survey was designed to be exploratory. Data were compared across specialties and geography. Results: The overall response rate was 8.3%. Of the respondents, 43%, 30% and 27% were family physicians, cardiologists and oncologists, respectively. A strong majority of respondents agreed that genetic testing and PM can have a positive impact on their practice; however, only 51% agreed that there is sufficient evidence to order such tests. A low percentage of respondents felt that they were sufficiently informed and confident practicing in this area, although many reported that genetic tests they have ordered have benefited their patients. Half of the respondents agreed that genetic tests that would be useful in their practice are not readily available. A lack of practice guidelines, limited provider knowledge and lack of evidence-based clinical information were cited as the main barriers to practice. Differences across provinces were observed for measures relating to access to testing and the state of practice. Differences across specialties were observed for the state of practice, reported benefits and access to testing. Conclusions: Canadian physicians recognise the benefits of genetic testing and PM; however, they lack the education, information and support needed to practice effectively in this area. Variability in practice and access to testing across specialties and across Canada was observed. These results support a need for national strategies and resources to facilitate physician knowledge, training and practice in PM.

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  • Professionals and patients fear discrimination based on the results of genetic testing, particularly by insurance companies or employers.

    “In addition to possible disparities in access to PM, professionals and patients fear discrimination based on the results of genetic testing [27, 79, 92, 97], particularly by insurance companies or employers [46, 51, 54, 63, 86, 94–96, 98, 115].”

    From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [27]

    In Results > State of practice (page unavailable), 40% of surveyed physicians reported that their patients had expressed fear of discrimination based on genetic testing. The paper does not say that the professionals themselves feared discrimination. The insurance-company and employer qualification has a separate group of citations in the citing sentence, so it is not assessed against this source. (LLM, conf=0.85)

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  • Many clinicians and researchers are well aware of the limited or ambiguous evidence for the meaning of test results and possible treatment outcomes and regard the lack of practice guidelines as a barrier for the implementation of tests.

    “Many clinicians and researchers are well aware of the limited [27, 30, 31, 35, 42, 79, 84] or ambiguous evidence [32] for the meaning of test results and possible treatment outcomes and regard the lack of practice guidelines as a barrier for the implementation of tests [27, 79].”

    From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [27]

    The Results (Barriers to adoption) report that 60% of surveyed physicians cited a lack of clinical guidelines and 53% cited a lack of evidence-based clinical information as main barriers. The Results (Attitudes and perceptions) also report that only 51% thought there was sufficient evidence to order genetic tests. The survey supports these points for physicians, but does not establish researchers’ views or specifically characterize evidence about the meaning of test results and possible treatment outcomes. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The majority of professionals have a positive attitude towards precision medicine in general or towards interventions labeled as precision medicine.

    “Various studies reveal that the majority of professionals have a positive attitude towards PM in general or towards interventions, which are mentioned under the label of PM [27, 34, 43, 45, 47, 50, 79–83].”

    From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [27]

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Research works printed but not linked: 31

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Authors
Bonter, K., Desjardins, C., Currier, N., Pun, J., & Ashbury, F. D.
Affiliations
  • Centre of Excellence in Personalized Medicine (Cepmed), Montreal, Québec, Canada
  • PricewaterhouseCoopers (Canada) (CA)
  • University of Calgary (CA)
Corresponding author
Desjardins, Clarissa
ORCID
Ashbury, Fredrick D
Venue
BMJ Open
Publisher
BMJ
Published
2011
Volume
1
Issue
1
Pages
e000110
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2011-000110
PMC
PMC3191410
OpenAlex
W2122448741
Cited by
111
References
1
Citations by year
2026: 2 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 9 · 2021: 15 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 9 · 2014: 14 · 2013: 10 · 2012: 6
FWCI
10.12
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Keywords
personalized medicine, genetic testing, physician attitudes, barriers to adoption, oncology, cardiology, general practice, access to genetic testing, physician knowledge and confidence, provincial variation, Canada

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