By Turna Ray
Canada's Center of Excellence in Personalized Medicine last week launched a personalized medicine portal developed in collaboration with DNA Direct.
Cepmed, a non-profit organization focused on encouraging adoption of personalized medicine in Canada, launched the portal in an effort to provide a reliable information source on advances in the space for people in the country. The portal, aimed at increasing physicians' knowledge and raising public awareness of personalized medicine, includes information on 44 genetic tests that can be used to inform treatment decisions and that are available in Canada as laboratory testing services.
Simultaneous with the launch of the Personalized Medicine Portal, Cepmed joined DNA Direct's Genomic Medicine Network. As a member of the GMN, Cepmed will be able to work with other personalized medicine stakeholders and conduct implementation studies to investigate how genetic tests are being used in real-world settings.
Last year, Cepmed surveyed more than 350 Canadian physicians and found that most docs felt that genetic testing and personalized medicine can positively impact their practice, but only 51 percent agreed that there is sufficient evidence to order such tests. Moreover, a "low percentage of respondents," around 29 percent, believed they were "sufficiently informed and confident practicing in this area" (PGx Reporter 10/12/2011).
"Canadians rely a lot on US sources of information. People go on the Internet to find out more about the medical care that they want or is being offered to them," said Katherine Bonter, Cepmed's director of advocacy and promotion. "We wanted to offer them … information about personalized medicine that's … coming from a reliable source."
Bonter said that Cepmed will spread the word about the portal through patient groups and physicians. "One major barrier to the adoption and development of personalized medicine is lack of education. Both physicians and patients need to be engaged in this kind of personalized decision making," Bonter told PGx Reporter. "Making all this information available publicly will help to facilitate awareness about the applications of personalized medicine that are currently applicable in the clinic."
DNA Direct, a subsidiary of the pharmacy-benefit manager Medco, is facilitating much of the educational materials about the genetic tests included in the portal. DNA Direct provides web-based genetic testing decision support and educational materials to US hospitals and medical centers.
"The reason we went to DNA Direct is because we didn't want to spend time recreating what already existed," Bonter said. "DNA Direct also has an advisory panel and genetic counselors. So the tests that are in [the portal] are to some degree in clinical use and clinically actionable."
In working with DNA Direct, Cepmed has "Canadian-ized" the Personalized Medicine Portal, she added. The public and doctors will be able to access data on genetic testing that is consistent with medical practice in their locale, on drugs that are referenced with their country-specific names; and on testing services that are available in each province.
Some tests included in DNA Direct's educational materials for the US aren't found in the Canadian version of the portal. For example, Bonter cited KIF6 testing as a means of promoting patient adherence to statins. "That test is just not done in Canada," Bonter said, adding that this is likely due to limited evidence on the efficacy of such testing.
Cepmed also plans to use the Personalized Medicine Portal to conduct implementation studies to track how genetic tests are being used in clinical practice. "We're working on establishing implementation studies primarily through private-public partnerships [around] clinically actionable tests that are available and we would study how those tests are used in practice," Bonter said. "Take a test that's already used. We want to study how that test gets used and we want to look at how the portal can be used to facilitate patient and physician decision making."
These implementation studies can further elucidate for stakeholders in the Canadian healthcare system what real-world barriers may be holding back adoption of certain genetic tests even when there is proof that the particular diagnostics are clinically useful.
Medco, for example, is using greater pharmacist-physician engagement and web-based portals to drive adoption of genetic tests in situations where there is evidence that such testing can improve patient outcomes or save healthcare dollars. Cepmed is considering similar strategies for the future.
Although the Personalized Medicine Portal is not currently intended to involve pharmacists, they "could play an incredibly important role in this and we view them as a key stakeholder," Bonter said. "We're not there yet, but if there was a way to involve pharmacists, that is something that we would take into consideration in designing an implementation study."
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