Delivering pharmacogenomic results via electronic health record patient portals: Impacts of health literacy and genetics knowledge.

Abstract

Pharmacogenetic testing is increasingly implemented clinically, which is effectively supported by both pharmacists and genetic counselors to counsel patients on these results. However, pharmacogenetic specialists are limited, and alternative service delivery methods need to be evaluated, including patient preferences and comprehension with pharmacogenetic counseling. This study assessed patients' views in relation to their health literacy and genetics knowledge on the communication of pharmacogenetic results through electronic health record (EHR) patient portals. Participants in a large, diverse biobank were electronically surveyed. Eighty-five percent of the cohort (580/682) indicated that they wanted their pharmacogenetic results added to the patient portal. Participants with a higher genetics knowledge were more likely to want their results added (p = 0.004), while health literacy did not have a significant impact. Participants with greater pharmacogenetic terminology familiarity (p = 0.004), better understanding of a mock patient-facing clinical pharmacogenetic report (p = 0.02), and greater self-reported ease of understanding the mock report (p < 0.0001), were more likely to want their results added to the patient portal. Furthermore, participants with higher health literacy (p < 0.0001), genetics knowledge (p < 0.0001), and familiarity with pharmacogenetic terminology (p < 0.0001) had greater understanding of the mock report. Taken together, this novel EHR-based pharmacogenetic survey of diverse patients determined that most participants favor using patient portals to communicate pharmacogenetic results. However, these results are counterbalanced by the importance of considering patient literacy in health and genetics when delivering pharmacogenetic results as well as the need for additional educational resources to support clinical pharmacogenetics implementation. Integrating pharmacogenetic results into patient portals offers a scalable approach to result delivery but should be paired with tailored education and support to ensure equitable patient understanding and engagement.