United States: Clinical Adoption Of Personalized Medicine

A recent study published in the American Journal of Medical Genetics, "Barriers for Integrating Personalized Medicine into Clinical Practice:  A Qualitative Analysis" investigated physicians' perceptions about the future of personalized medicine and identified factors that would influence their decisions in using genetic testing in their practice. The study is an interesting read for any innovator in genomic testing and analysis and provides insight into what factors will facilitate adoption of genetic testing into clinical care.

Study Design

The authors of the study, Mehdi Najafzadeh, Jennifer C. Davis, Pamela Joshi and Carlo Marra, conducted three semi-structured groups of physicians currently practicing in British Columbia (BC). Two of three groups were in urban areas and the third was in a rural setting. Each group was moderated by facilitators that assured coverage of the following pre-defined topics:

  1. Physicians' general understanding of personalized medicine;
  2. Perceived advantages of personalized medicine;
  3. Effect of personalized medicine on future of clinical practice; and
  4. Perceived barriers to integration of personalized medicine into clinical practice.

Twenty-eight physicians participated in three focus groups conducted at different locations. The majority of physicians that participated were male (67.9%) and the median age among those who reported their age was 50 years old. The mean number of years practicing among physicians was 21.0 (SD=11.2). The authors note that interestingly, the majority (approximately 68%) of participants indicated their interest in using personalized medicine in their practice if they could have access to the necessary knowledge and tools. About 22% were reported to be against the idea of applying personalized medicine and 10% of the physicians were undecided.

Results and Analysis

Physicians' General Understanding of Personalized Medicine

The authors report that about 36% of physicians self-reported that they were not familiar at all with the concept of personalized medicine prior to participation in the focus groups. Some understood that personalized medicine was the application of personal genomics to tailored treatments, while others were reported to understand it to be clinical care focused on the individual (e.g., health care management for the particular patient) and did not have any relationship to the patient's genes, a patient's family history, social history or ethnic background. Yet others were reported to believe that personalized medicine related to wealthier patients having access to personalized health care.

Perceived Advantages and Disadvantages of Personalized Medicine

Perceived major advantages of personalized medicine included improved effectiveness and a reduction in adverse effects in treatments. Uncertainty in validity, equity issues and implementation were identified as perceived disadvantages.

Uncertainty around the validity of genomic tests given the complexity of gene expression was mentioned as a major concern. In addition, substantial financial incentives for private companies for excessive marketing of their services, possible mishandling of genomic information by private companies and discrimination based on genomic information (by, for example, insurance companies, private companies and the health care system), were reported disadvantages. Lack of public knowledge about genomic tests, possible harmful impacts to patients after use and reporting of results, and affordability of genetic tests, were reported implementation barriers.

Effect of Perssonalized Medicine on Future Clinical Practice

The study participants were reported to widely believe that genetic developments will directly affect their medical practice in the future; however, they also were reported to express differing viewpoints on the timing and potential influences. Some physicians reported to have already received requests from patients for interpretation of direct-to-consumer (DTC) genetic test results, and thus, advances in genomics were already influencing clinical practice. Others opined that the effect of genomics on clinical practice might take more than 10 years to be realized.

Barriers to Integrating Personalized Medicine into Clinical Practice

The reported barriers to implementation into clinical practice included lack of training about genomic tests and interpretation of results. A lack of clinical guidelines and protocols on the use of genomic tests were other key issues of concern to the physicians. The physicians also noted that the complexity of reporting and interpreting test results to patients were additional barriers to implementation.

Discussion and Notes For Innovators

In conclusion, the authors believe that despite the challenges that personalized medicine can create for the participating physicians; there was a general interest in using genetic information in their practice. The authors also believe that physicians expected to have access to training opportunities and clinical guidelines in order to use the genomic testing and interpret the results. Interesting, the authors noted that the cost of genomic testing and who would pay for the tests was one of the reported major themes raised in the focus groups.

The authors also raise the point that although many genomic tools are not currently ready for clinical practice, there was a consensus among the study participants that given the fast pace of genomic science, there is a need to be prepared for evaluating and implementing technologies upon their availability. The authors opine that creating the capacity in the health care system can be a lengthy and timely reaction to advanced medical technologies can maximize the benefits and minimize the harms associated with their use.

The authors note that many of the physicians in the study received their medical training before any of the currently available genetic tests existed. While the authors state that this highlights the responsibility of organizations that are involved with training physicians and the oversight of medical care to provide adequate training and education, innovators who develop and market such tests should also appreciate that many practicing physicians presently lack the support and training to interpret and communicate test results to patients.

Clinical application of genetic information to inform treatment decisions, a basic application of personalized medicine, must therefore understand and meet the needs of a primary consumer – the treating physician. Thus, training and on-going support to physicians and genetic counselors (that support physicians) are important to successful adoption of genomic tests that support personalized health care.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Topics
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions