Aims/hypothesis
Advances in type 2 diabetes genetics have raised hopes that genetic testing will improve disease prediction, prevention and
treatment. Little is known about current physician and patient views regarding type 2 diabetes genetic testing. We hypothesised
that physician and patient views would differ regarding the impact of genetic testing on motivation and adherence.
Methods
We surveyed a nationally representative sample of US primary care physicians and endocrinologists (n = 304), a random sample of non-diabetic primary care patients (n = 152) and patients enrolled in a diabetes pharmacogenetics study (n = 89).
Results
Physicians and patients favoured genetic testing for diabetes risk prediction (79% of physicians vs 80% of non-diabetic patients
would be somewhat/very likely to order/request testing, p = 0.7). More patients than physicians (71% vs 23%, p < 0.01) indicated that a ‘high risk’ result would be very likely to improve motivation to adopt preventive lifestyle changes.
Patients favoured genetic testing to guide therapy (78% of patients vs 48% of physicians very likely to request/recommend
testing, p < 0.01) and reported that genetic testing would make them ‘much more motivated’ to adhere to medications (72% vs 18% of physicians,
p < 0.01). Many physicians (39%) would be somewhat/very likely to order genetic testing before published evidence of clinical
efficacy.
Conclusions/interpretation
Despite the paucity of current data, physicians and patients reported high expectations that genetic testing would improve
patient motivation to adopt key behaviours for the prevention or control of type 2 diabetes. This suggests the testable hypothesis
that ‘genetic’ risk information might have greater value to motivate behaviour change compared with standard risk information.
Keywords Diabetes prediction - Genetic risk - Genetic testing - Medication adherence - Patient motivation - Type 2 diabetes