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Table 3 Main topics and findings discussed relating to pharmacogenomics and potential unintended negative consequences

From: Leveraging the utility of pharmacogenomics in psychiatry through clinical decision support: a focus group study

Summary of major points addressed from the focus groups
  Use of pharmacogenomics Potential negative consequences
Major points raised during discussion The results summary is generally sufficient Physicians do consult the full report if: Unfamiliar with vendor Desire in-depth analysis Clinical consideration PGx is generally not used as a first step Generally saved for poor responders or bizarre symptoms Can be used to satisfy worried parents and patients Providers-PGx trust is important to act on PGx results Providers are more likely to trust familiar vendors Allele and metabolizer information is important Physical PGx reports may be handed to patients To serve as a prop To allow patients to supply other providers with PGx results Current shortcomings with using PGx at the point of care Clinicians have difficulty incorporating PDF reports in their workflow PGx information does not integrate with patient information such as current and prospective medications at the point of prescribing Alert fatigue Unnecessary alerts should be avoided to limit distraction from important alerts However, a lack of critical alerts is also negative Difficulty to input relevant information This type of information includes: Ratings/scores from third party vendors Hand-written lab reports Addition of time to the length of visit Providers generally only have 30 min for an examination Providers are unlikely to use tools that increase time Proper position of the CDS within the workflow will increase efficiency Clinicians may lack trust in displayed data Past experiences with CDS suggest not all relevant data are surfaced properly Confirmation of the accuracy of information will ease some of these concerns Frustration using CDS Clinicians often deal with slow and inconsistent CDS Clinicians will discard cumbersome CDS