Do Physicians Think Genomic Medicine Will Be Useful for Patient Care?

Sridharan Raghavan; Jason L Vassy

Disclosures

Personalized Medicine. 2014;11(4):425-433. 

In This Article

Motivating Patient Behavior Change

A second way physicians might believe genomic testing to have clinical value is as a tool for counseling patients for health behavior change. However, Grant et al. found that only 23% of physicians surveyed believed that knowledge of a high genetic susceptibility to Type 2 diabetes would motivate patient behavior change. Similarly, Bernhardt et al. found in their survey addressing US primary care physician attitudes towards DTC genomic testing that only 10–15% of respondents who consider genomic testing potentially clinically useful would use the test results for diabetes and cardiovascular disease risk to counsel patient behavioral change. In contrast, among all survey respondents, approximately 45% reported that genomic testing would motivate patients to adopt healthier behaviors.[12] These results suggest that physicians may be skeptical about the ability of genomic risk information to motivate patients to change their dietary and physical activity habits to prevent chronic disease.

Unlike the potential application of genomic test results to risk stratification, the use of genomic testing for counseling patient behavior change has been evaluated in randomized clinical trials. For example, trials of genomic testing for Type 2 diabetes risk have not demonstrated improvements in patient health behaviors and outcomes.[20–22] In a systematic review of genetic testing for motivating a variety of behaviors, including smoking cessation, dietary modification and increased physical activity, there was a measurable disparity between intention to change behavior based on genetic test results and actual behavior change.[23] These empiric findings seem to confirm the physician skepticism captured in surveys about the use of genomic testing to motivate patients. Behavior change has proven a challenging problem across many chronic illnesses, and the negative findings in initial trials of genomics for motivating lifestyle modification may indicate the need for more intensive counseling or assistance to achieve the desired behavioral transformation.

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