Cardiologists’ Perspectives on Pharmacogenomics: Utilization, Barriers, And the Role of Genetic Counselors

Abstract

Pharmacogenomics (PGx) has the potential to personalize cardiovascular treatment byoptimizing drug efficacy and minimizing adverse drug reactions. Despite well-established guidelines for PGx-informed prescribing, its integration into cardiology remains limited. In this study, we conducted a nationwide survey to assess cardiologists’ knowledge, utilization, and perceptions of PGx testing, as well as their views on the role of genetic counselors in this space. The survey was distributed via email, flyers, and social media, utilizing a snowball sampling method. A total of 63 responses were included in the analysis. The majority of respondents were white, male, and practicing adult general cardiology. Most (58%) reported having no or only limited knowledge of PGx, and 55% had never ordered PGx testing in their practice. We found statistically significant positive correlations between provider degree of PGx knowledge and the frequency of test ordering (p = 1.226e-09), provider confidence in result interpretation, (p < 2.349e-16) and confidence with communicating test results (p = 6.968e-13). Additionally, many cardiologists expressed some interest in the integration of genetic counselors into PGx workflows, highlighting an opportunity for increased interdisciplinary collaboration. Notably, there was a statistically significant positive correlation between cardiologists’ perceived impact of genetic counselors involved in PGx and their likelihood to refer patients to them for PGx testing (p = 3.004x10⁻⁶). PGx is an emerging field with the potential to improve patient outcomes and reduce healthcare costs, yet gaps in provider knowledge and confidence hinder its clinical use. Expanding provider education and incorporating genetic counselors into cardiology and PGx workflows may facilitate broader adoption of PGx testing and enhance personalized treatment strategies in cardiovascular care.