Date of Award

2015

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Mathew Gregoski

Second Advisor

Carolyn H. Jenkins

Third Advisor

Bonnie P. Dumas

Fourth Advisor

Kathy Baker

Abstract

Anesthesia care is delivered world wide on a daily basis. Provision of anesthesia cares for surgical, obstetrical, or pain management procedures mandate a thorough understanding of physiology, pathophysiology, and pharmacology. Nearly 4 million anesthetics are delivered in the United States each year and the impact of genetics on anesthesia care is becoming greater. Anesthesia providers make prescriptive decisions based on an individual patient's disease processes, proposed surgical or therapeutic procedure, and a thorough clinical history. The age of personalized medicine is upon us and the ability to use genetic testing to help predict how a patient will respond to various medications is here. By using genetically coded single nucleotide polymorphism programming of the metabolic pathways in the liver, drugs responsiveness can be more precisely predicted and explained. This dissertation focuses on the clinical utility of genetic testing to predict drug responsiveness (pharmacogenomics) among anesthesia providers with a focus on treating acute pain. Specifically, the following research question is addressed: What is the clinical utility of pharmacogenomic testing to support prescriptive decision making among anesthesia providers. To answer this research question, a mixed-method sequential qualitative quantitative study was carried out. The conclusions of this research are (a) anesthesia providers lack knowledge concerning pharmacogenomic testing, (b) anesthesia providers are concerned about potential ethical and economic issues surrounding genetic testing, and (c) anesthesia providers perceive a potential benefit to using pharmacogenomic testing as it relates to making prescriptive decisions. Further work is necessary to more carefully refine the instrument used to measure clinical utility as well as future intervention work aimed at increasing anesthesia provider knowledge about pharmacogenomic testing.

Rights

All rights reserved. Copyright is held by the author.

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