• Wed, Mar 19 2008

Integrating genetic medicine into doctors’ surgeries

Following my recent article titled “Genetic testing – ‘recreational genomics’ or the future of diagnostics”, I queried why doctors were finding it challenging to provide their patients with adequate information on genetic testing and I questioned whether there should be increased availability of training courses to help support doctors.

On cue, a report published in JAMA concludes just that … although doctors know quite a bit about genomic medicine, it is still not being integrated into their clinical practice.  The report also argues that genomic medicine should be a part of the risk assessment and treatment of common chronic diseases such as cardiovascular disease, diabetes mellitus, and cancer.

In this systematic review, Dr Maren T. Scheuner, M.D., M.P.H. (RAND Corporation, Santa Monica, Calif.) and colleagues examined research articles and other systematic reviews from the medical literature that were published from January 2000 to February 2008 and that focused on common, chronic, adult-onset conditions. The search resulted in 68 articles that assessed four specific areas:

  1. Genomic medicine outcomes
  2. Information needs of consumers
  3. Genomic medicine delivery
  4. Challenges and barriers to integrating genomic medicine

Dr Scheuner writes “The greatest public health benefit of advances in understanding the human genome will likely occur as genomic medicine expands from its focus from rare genetic disorders to inclusion of more common chronic diseases, such as coronary heart disease, stroke, diabetes mellitus, and cancer.  With genomics discoveries relating to common chronic diseases, numerous genetic tests may emerge that hold promise for significant changes in the delivery of health care, particularly in preventive medicine and in tailoring drug treatment.”
 

Along with the noted unpreparedness of the primary care workforce, there are several other barriers to integrating genomic medicine with the traditional methods for treating and preventing common chronic diseases. “The most prominent of these include health professionals’ lack of basic knowledge about genetics and their lack of confidence in interpreting familial patterns of disease, which limits their ability to appropriately counsel their patients, order and accurately interpret genetic tests, and refer their patients for genetics consultation.” say the authors.

The report concludes by advising it will be a lost opportunity if the health services fail to keep pace with the rapid basic science advances and clinical discoveries.

For further information on the report, click on:

http://jama.ama-assn.org/cgi/content/abstract/299/11/1320

Elaine Warburton  www.geneticsandhealth.com

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