Physician Experience with Direct-To-Consumer Genetic Testing in Kaiser Permanente.

Jonas MC1, Suwannarat P2, Burnett-Hartman A3, Carroll N4, Turner M5, Janes K6, Truong C7, Blum-Barnett E8, Aziz N9, McGlynn EA10.

Author information

1: Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, Rockville, MD 20852, USA. Cabell.Jonas@kp.org.
2: Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, Rockville, MD 20852, USA. Pim.Suwannarat@kp.org.
3: Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO 80014, USA. Andrea.N.Burnett-Hartman@kp.org.
4: Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO 80014, USA. Nikki.M.Carroll@kp.org.
5: University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA. Michelle.Turner@cuanschutz.edu.
6: Kaiser Permanente National Quality, Oakland, CA 94611, USA. Kristen.X.Janes@kp.org.
7: Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, Rockville, MD 20852, USA. ChristinexTruong@gmail.com.
8: Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO 80014, USA. Erica.Blum-Barnett@kp.org.
9: Variant Genomics, Inc., Oakland, CA 94611, USA. Nazneen.Aziz@variant-genomics.com.
10: Kaiser Permanente Research, Pasadena, CA 91101, USA. Elizabeth.A.McGlynn@kp.org.

Abstract

Health systems and physicians nationwide aspire to consistently and reliably apply genetic and genomic information to guide disease prevention, management, and treatment. However, clinical information, including genetics/genomics data from within and outside of the care delivery system, is expanding rapidly. Between November 2017 and April 2018, we surveyed 1502 Permanente Medical Group primary care and specialist physicians to assess the degree to which direct-to-consumer genetic test results were being presented to physicians and identify genetics educational needs among physicians (response rate 15%). Adjusted logistic regression (according to respondent characteristics) was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing responses within groups. Results showed 35% and 12% of respondents reported receiving at least one direct-to-consumer health risk genetic result (DTC-health risk) or direct-to-consumer pharmacogenomic test result (DTC-PGx), respectively, from a patient in the past year. Of those receiving at least one test result, 40% (DTC-health risk) and 39% (DTC-PGx) of physicians reported 1+ referral(s); 78% (DTC-health risk) and 42% (DTC-PGx) of referrals were to clinical genetics. In total, 85% of physicians would spend ≥2 h/year on genetics/genomics education.