The Pharmacogenetics Project
Through participatory research workshops, ethnographic probes and online forms done with physicians and pharmacists, this project identifies the clinicians' attitudes and perspectives towards emerging digital technologies like pharmacogenetics (PGx).
Role
Research Assistant at the Health Design Lab
Team
Allison Chan - Research Assistant
Andrew Siu - Strategic Advisor
Haig Armen - Faculty
Timeline
October 2019 - June 2020
Objectives
Identify the clinician’s perspective, knowledge
and attitude of PGx
Formulate a method to measure the shift in physician’s perspective
Create tools that can be used later to facilitate further investigations
Plans to host in- person workshops were set in place from the get-go. However, the COVID-19 pandemic put a halt in the schedule, as the province of BC was instructed to practice social distancing. In order to carry out the research, the team took the necessary measures to adapt to the situation.
Secondary Research
To start off our research, we looked into existing research material. The list of resources comprises mostly of academic studies. Using the information we gathered from these sources, we created maps that reflected our understanding.
Co-design Workshop with GenomeBC
The team lead a co-design session with six participants from Genome BC at their offices on Friday, January 17th, 2020. The goal of the session was to help us get a better understanding of what we want to learn from the workshop that we will be having with physicians and pharmacists in February.
With our findings from the activities, we were able to:
• Address and validate some of the themes found in our secondary research
• Identify “Trust” an overarching theme
• Use the information that we will later retrieve in the physician’s workshop to compare and contrast the findings that we received from this workshop with Genome BC
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Participants in action at the Genome BC Workshop
Allison (chanallison.com) and I at Genome BC
Physician Workshop + Probe
Due to the COVID-19, we were not able to complete the physician’s workshop. We planned to send these probe kits to physicians that were not able to attend our workshop as a remote version of the workshop.
The activities in the workshop and probe will help us learn about a clinician’s understanding of pharmacogenetics, what sources of information they find trustworthy, and how they see its application improving their clinical practice. Both the workshop and probe includes the following activities:
1.) Empathy Study - An activity about the physician’s perspective and understanding of PGx,
2.) Mapping Your Sources - An activity about understanding what sources of information are trusted and accessed by physicians, and
3.) Imagining the Future - An activity that gets physicians to think about how they envision pharmacogenetics will impact their work and to determine if they find this practice valuable.
Physician Workshop + Probe
In order to adapt to the COVID-19 social distancing protocols, we created a remote survey for clinicians to participate in. We sent this survey out via Emily Carr Health Design Lab’s social media accounts and newsletter. Our project partners also helped send the survey out to physicians and pharmacists. We made sure that the survey was relatively short in length (about 15 minutes to complete).
We made a Typeform survey for our questions. We included a consent form in the beginning as well as an invitation for their emails at the end. We also created different logic jumps depending on each participant’s level of knowledge and experience of pharmacogenetics. The first part of the survey included questions about pharmacogenetics. After completing them, the participant is redirected to the second part of the survey that included questions about their personal practice. This ensured that we could receive their answers about pharmacogenetics if they did not complete the full survey.
We made a Typeform survey for our questions. We included a consent form in the beginning as well as an invitation for their emails at the end. We also created different logic jumps depending on each participant’s level of knowledge and experience of pharmacogenetics. The first part of the survey included questions about pharmacogenetics. After completing them, the participant is redirected to the second part of the survey that included questions about their personal practice. This ensured that we could receive their answers about pharmacogenetics if they did not complete the full survey.
Key Themes
Between all the activities that were completed, we were able to find recurring themes and combined them into 5 larger key themes:
Conclusion from Themes
More time and research will be needed to validate our findings, as well as for PGx technology to be demystified/widespread/less expensive.
With these themes in mind, it should be noted that PGx has still not been implemented into many clinicians’ practices as there has not been enough clinical evidence for its effectiveness. It will be difficult for clinicians to fully trust this new care method and have it be fully integrated into their field of practice unless more time has passed for the technology to become demystified, less expensive, and widespread in use. That being said, the themes that we have found in our research will need to be examined further before any of the insights can be applied to the PGx implementation process.
It should be noted that more time should be spent validating and investigating these themes and findings. This round of research serves as a starting point. For the next series of investigations, the research activities should reinforce, deepen or even challenge our findings.
These values might change overtime and need to be monitored regularly.
As PGx technology advances, clinicians will be more and more willing to adopt and implement. Values and perspectives will slowly change and it will be important to document and monitor those changes. It will also be useful to compare and analyze perspectives from different times.
Different biases exist within responses depending on the demographics of participants
As we have seen in this round of research, the lack of the patient perspective resulted in many unanswered questions. Many of our survey participants were already familiar with PGx or already using it- this most likely affected our insights to have a more positive outlook on PGx. The next step to take with these themes is to investigate them further with the participation of physicians, pharmacists, patients, policy makers and other stakeholders who may or may not have experience with PGx. It will be really important to understand their goals, concerns and needs surrounding PGx as a new technology to find actionable insights and develop potential solutions that work for all parties involved with the implementation of PGx.
Must consider the overlaps between the themes (interconnected rather than separate).
Although we examined these themes separately in this report, they have problem spaces that overlap with one another and are often interconnected. It will be useful to consider how each theme influences another, such as how there is a lack of educational resources on PGx for graduates as a result of lack of funding in this area. As well, the lack of coordination between primary care professionals and other specialists creates a barrier for implementing new care methods.
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