Knowledge and Attitudes of the Healthcare Providers in the United Arab Emirates toward the Reports of the Pharmacogenomics in Cardiovascular Disease Randomized Clinical Implementation “EmHeart” study: A Cross sectional study

Main Article Content

Zeina Al-Mahayri
Emad Masuadi
Mohammed Al-Saadi
Khalid AlMaamari
Omar Al Zaabi
Saoud Altamimi
Khalifa Al-Seiari
Nasser Al-Shamsi
Hajar Alktifan
Maryam Alktifan
Basma Beiram
Bassam Ali
Azhar Rahma

Keywords

Pharmacogenomics, pharmacists, physicians, The Diffusion of Innovations theory, Technology Acceptance Model, UAE

Abstract

Introduction: The “EmHeart” study, a randomized multicenter clinical trial, was launched in 2021 to investigate the implementation of pharmacogenomics (PGx) in the UAE, with a focus on cardiovascular patients taking clopidogrel, warfarin, atorvastatin, and rosuvastatin. Despite their potential benefits, clinicians' reluctance to use PGx testing and their results in clinical practice warrants evaluation. The Diffusion of Innovations (DOI) theory and the Technology Acceptance Model (TAM) are used in this study to compare attitudes and knowledge among healthcare providers, identify useful and confusing report components, and assess healthcare practitioners' attitudes toward PGx reports. Methods: A cross-sectional study employing a validated questionnaire to explore physicians' and pharmacists' knowledge and attitudes in the UAE. Participant recruitment used the Shafafiya portal with random and convenience sampling approaches.  For statistical analysis, the sample size was calculated using the Raosoft website. Data entry and analyses were performed using the statistical package IBM SPSS. The Abu Dhabi Health Research and Technology Ethical Committee provided ethical approval (reference DOH/CVDC/2020/1187). Results: The study included 264 participants, split roughly equally between males and females. Around  50% (131) were between the ages of 25 to 34 years old. Nearly one-third were physicians, and one-third had been practicing healthcare for less than five years. Only 32 (12.1%) were Emirati nationals with the rest being expatriate health care workers, and one-third of the participants had not heard of PGx tests before, and only 5% had ordered a PGx test for their patients. The participants’ overall mean score of the attitude toward the PGx tests was [3.79; 95% CI= (3.74, 3.84)]. However, the overall mean knowledge score was [71.5; 95% CI= (68.2, 74.8)]. Conclusions: The findings suggest that direct experience with PGx reports significantly enhances knowledge and attitudes, whether in a real patient context or educational setting. We are, therefore, advocating for targeted educational initiatives and training programs in pharmacogenomics.

Abstract 111 | PDF Downloads 45

References

1. Cecchin E, Stocco G. Pharmacogenomics and Personalized Medicine. Genes (Basel). 2020;11(6):679. doi:10.3390/genes1106067.
2. Malhotra A. AN INTRODUCTION TO PHARMACOGENOMICS. In: Vol 12. ; 2015. https://www.nhpf.org/library/background_papers/BP_Pharmacogenomics_01-28-08.pdf.
3. Malsagova KA, Butkova TV, Kopylov AT, et al. Pharmacogenetic Testing: A Tool for Personalized Drug Therapy Optimization. Pharmaceutics. 2020;12(12):1240. doi:10.3390/pharmaceutics12121240.
4. Jones LK, Kulchak Rahm A, Gionfriddo MR, et al. Developing Pharmacogenomic Reports: Insights from Patients and Clinicians. Clin Transl Sci. 2018;11(3):289-295. doi:10.1111/cts.12534.
5. Abdela OA, Bhagavathula AS, Gebreyohannes EA, Tegegn HG. Ethiopian health care professionals’ knowledge, attitude, and interests toward pharmacogenomics. PGPM. 2017;10:279-285. doi:10.2147/PGPM.S145336.
6. Albassam A, Alshammari S, Ouda G, Koshy S, Awad A. Knowledge, perceptions and confidence of physicians and pharmacists towards pharmacogenetics practice in Kuwait. PLoS One. 2018;13(9):e0203033. doi:10.1371/journal.pone.0203033.
7. AlEjielat R, Ejielat Z, Andrawes S, Mhaidat NM. An evaluation of the knowledge, opinions, expectations and concerns toward pharmacogenomics among Jordanian pharmacists. Per Med. 2016;13(2):143-154. doi:10.2217/pme.15.50.
8. Algahtani M. Knowledge, Perception, and Application of Pharmacogenomics Among Hospital Pharmacists in Saudi Arabia. RMHP. 2020;13:1279-1291. doi:10.2147/RMHP.S267492.
9. Arafah A, Rehman MU, Syed W, Babelghaith SD, Alwhaibi A, Al Arifi MN. Knowledge, Attitude and Perception of Pharmacy Students towards Pharmacogenomics and Genetics: An Observational Study from King Saud University. Genes (Basel). 2022;13(2):269. doi:10.3390/genes13020269.
10. Baroncini A, Calabrese O, Colotto M, Pelo E, Torricelli F, Boccia S. Knowledge and attitude of general pratictioners towards direct-to-consumer genomic tests: a survey conducted in Italy. Epidemiology, Biostatistics, and Public Health. 2015;12(4). doi:10.2427/11613.
11. Etchegary H, Cappelli M, Potter B, et al. Attitude and knowledge about genetics and genetic testing. Public Health Genomics. 2010;13(2):80-88. doi:10.1159/000220034.
12. Karuna N, Tragulpiankit P, Mahasirimongkol S, Chumnumwat S. Knowledge, attitude, and practice towards pharmacogenomics among hospital pharmacists in Thailand. Pharmacogenet Genomics. 2020;30(4):73-80. doi:10.1097/FPC.0000000000000399.
13. Rahma AT, Elsheik M, Ali BR, et al. Knowledge, Attitudes, and Perceived Barriers toward Genetic Testing and Pharmacogenomics among Healthcare Workers in the United Arab Emirates: A Cross-Sectional Study. J Pers Med. 2020;10(4):216. doi:10.3390/jpm10040216.
14. Al-Mahayri ZN, Khasawneh LQ, Alqasrawi MN, et al. Pharmacogenomics implementation in cardiovascular disease in a highly diverse population: initial findings and lessons learned from a pilot study in United Arab Emirates. Human Genomics. 2022;16(1):42. doi:10.1186/s40246-022-00417-9.
15. Al-Mahayri ZN, Al Jaibeji HS, Saab Y, et al. VKORC1 variants as significant predictors of warfarin dose in Emiratis. Pharmgenomics Pers Med. 2019;12:47-57. doi:10.2147/PGPM.S187350.
16. Stanek EJ, Sanders CL, Taber KAJ, et al. Adoption of Pharmacogenomic Testing by US Physicians: Results of a Nationwide Survey. Clinical Pharmacology & Therapeutics. 2012;91(3):450-458. doi:10.1038/clpt.2011.306.
17. Alqasrawi MN, Al-Mahayri ZN, Alblooshi H, Alsafar H, Ali BR. Utilizing Pharmacogenomic Data for a Safer Use of Statins among the Emirati Population. Curr Vasc Pharmacol. 2024;22(3):218-229. doi:10.2174/0115701611283841231227064343.
18. Khasawneh LQ, Alsafar H, Alblooshi H, Allam M, Patrinos GP, Ali BR. The diversity and clinical implications of genetic variants influencing clopidogrel bioactivation and response in the Emirati population. Hum Genomics. 2024;18(1):2. doi:10.1186/s40246-023-00568-3.
19. Micaglio E, Locati ET, Monasky MM, Romani F, Heilbron F, Pappone C. Role of Pharmacogenetics in Adverse Drug Reactions: An Update towards Personalized Medicine. Front Pharmacol. 2021;12. doi:10.3389/fphar.2021.651720.
20. Principi N, Petropulacos K, Esposito S. Impact of Pharmacogenomics in Clinical Practice. Pharmaceuticals (Basel). 2023;16(11):1596. doi:10.3390/ph16111596.
21. Digital T. Healthcare Guidelines | Department of Health Abu Dhabi. Accessed June 26, 2024. https://www.doh.gov.ae/en/resources/guidelines.
22. Silva P. Davis’ Technology Acceptance Model (TAM) (1989). In: Information Seeking Behavior and Technology Adoption: Theories and Trends. IGI Global; 2015. https://www.igi-global.com/gateway/chapter/127133.
23. Eysenbach G. Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Journal of Medical Internet Research. 2004;6(3):e132. doi:10.2196/jmir.6.3.e34.
24. Nair A, Chacko J, Pillai S. A knowledge, attitude, and practices study of pharmacogenomics and its educational needs among doctors in a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2018;(0):1. doi:10.5455/njppp.2019.9.0722522112018.
25. Smith DM, Namvar T, Brown RP, et al. Assessment of Primary Care Practitioners’ Attitudes and Interest in Pharmacogenomic Testing. Pharmacogenomics. 2020;21(15):1085-1094. doi:10.2217/pgs-2020-0064.
26. Kudzi W, Addy BS, Dzudzor B. Knowledge of Pharmacogenetics among Healthcare Professionals and Faculty Members of Health Training Institutions in Ghana. Ghana Med J. 2015;49(1):50-56.
27. Just KS, Steffens M, Swen JJ, Patrinos GP, Guchelaar HJ, Stingl JC. Medical education in pharmacogenomics—results from a survey on pharmacogenetic knowledge in healthcare professionals within the European pharmacogenomics clinical implementation project Ubiquitous Pharmacogenomics (U-PGx). Eur J Clin Pharmacol. 2017;73(10):1247-1252. doi:10.1007/s00228-017-2292-5.
28. Z B, S B, Mz S, Lk T. Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals. imjm. 2014;13(1). doi:10.31436/imjm.v13i1.491.
29. Wondrasek A, Fryza A, Aziz MdA, Leong C, Kowalec K, Maruf AA. Knowledge, perceptions, and attitudes toward pharmacogenomics among pharmacists and pharmacy students: A systematic review. Health Sci Rep. 2024;7(1):e1844. doi:10.1002/hsr2.1844.
30. Ong CSB, Fok RW, Tan RCA, Fung SM, Sun S, Ngeow JYY. General practitioners’ (GPs) experience, attitudes and needs on clinical genetic services: a systematic review. Fam Med Community Health. 2022;10(4):e001515. doi:10.1136/fmch-2021-001515.
31. Khattab M, Baguneid M, Ali BR, et al. A review of pharmacogenomics studies assessing the knowledge and attitudes of physicians and pharmacists across the Arab and Middle Eastern Region. Pharmacy Practice. 2023;21(3):1-12. doi:10.18549/PharmPract.2023.3.2828.
32. Guy JW, Patel I, Oestreich JH. Clinical Application and Educational Training for Pharmacogenomics. Pharmacy (Basel). 2020;8(3):163. doi:10.3390/pharmacy8030163.
33. Elewa H, Alkhiyami D, Alsahan D, Abdel-Aziz A. A survey on the awareness and attitude of pharmacists and doctors towards the application of pharmacogenomics and its challenges in Qatar. J Eval Clin Pract. 2015;21(4):703-709. doi:10.1111/jep.12372.
34. Brown JT, McGonagle E, Seifert R, Speedie M, Jacobson PA. Addressing disparities in pharmacogenomics through rural and underserved workforce education. Front Genet. 2023;13:1082985. doi:10.3389/fgene.2022.1082985.
35. Chang A, Nelson R, Brixner D. Advancing pharmacy practice by reducing gaps in pharmacogenetic education. American Journal of Health-System Pharmacy. 2019;76(5):320-326. doi:10.1093/ajhp/zxy066.
36. Preys CL, Blout Zawatsky CL, Massmann A, et al. Attitudes about pharmacogenomic testing vary by healthcare specialty. Pharmacogenomics. 2023;24(10):539-549. doi:10.2217/pgs-2023-0039.
37. Rahma AT, Elbarazi I, Ali BR, et al. Development of the pharmacogenomics and genomics literacy framework for pharmacists. Human Genomics. 2021;15(1):62. doi:10.1186/s40246-021-00361-0.
38. Levy KD, Blake K, Fletcher-Hoppe C, et al. Opportunities to implement a sustainable genomic medicine program: lessons learned from the IGNITE Network. Genet Med. 2019;21(3):743-747. doi:10.1038/s41436-018-0080-y.

Most read articles by the same author(s)