238070 Personalized medicine in critical care: Provider knowledge, attitudes and perceptions and implications for training and practice

Sunday, October 30, 2011

Ellen Iverson, MPH , Community Health Outcomes and Intervention Research, Children's Hospital Los Angeles, Los Angeles, CA
Rita Burke, PhD, MPH , Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA
Adriana Armenta , Community Health Outcomes and Intervention Research, Children's Hospital Los Angeles, Los Angeles, CA
Erica Shehane, MPH, MSW , Community Health Outcomes and Intervention Research, Childrens Hospital Los Angeles, Los Angeles, CA
Maryann Nyc , Department of Pediatric Critical Care, University of California, Los Angeles, Los Angeles, CA
Rick Harrison, MD , Department of Pediatric Critical Care, Univeristy of California, Los Angeles, Los Angeles, CA
Christopher Newth, MD , Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Jeffery Upperman, MD , Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA
With the emergence of personalized medicine, tailoring treatment to patients' genetic profiles, genetic testing in clinical settings is becoming increasingly common. In the stressed critical care setting, application of personalized medicine presents unique challenges. This mixed methods study examined provider knowledge and perceptions related to genetics and personalized medicine and its social and ethical implications in pediatric critical care units of two large medical centers. The study team conducted 11 focus groups with 57 critical care physicians, nurses, social workers (SW) and genetic counselors (GC). Findings informed the development of an online survey completed by 181 critical care providers. Survey findings revealed that, while all GCs were familiar with the term personalized medicine, 25% MDs, 75% nurses and SWs were not. Except GCs, 70% or more of each provider group self-reported low/very low knowledge of genetics. Over 75% agreed that the majority of patients' parents do not understand what a genetic test is; 82% of MDs, nurses and SWs agreed that insurance companies would use a child's genetic data to determine premiums. Over 50% believed GCs should be the primary provider to communicate the results to the family. Focus group discussions revealed mixed perceptions about misuse of genetic results. Most believed that a multi-disciplinary team approach to personalized medicine would ensure quality interpretation and communication to families; many questioned its feasibility in critical care. If the collection of genetic data becomes routine, critical care providers must be prepared and equipped to provide clear and accurate information to patients and families.

Learning Areas:
Advocacy for health and health education
Clinical medicine applied in public health

Learning Objectives:
1. To define “personalized medicine” 2. To compare providers’ attitude toward communicating genetic testing results to patients’ families 3. To discuss providers’ perceptions of their patients’ ability to understand what a genetic test is

Keywords: Pediatrics, Genetics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-PI of this study. I was directly involved in its design, data collection and analysis as well as the preparation of this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Issues in Public Health Genomics
See more of: Genomics Forum