PII-082 - PERSPECTIVES ABOUT THE DEVELOPMENT AND IMPLEMENTATION OF PHARMACOGENOMIC CLINICAL DECISION SUPPORT TOOLS IN RURAL AND UNDERSERVED COMMUNITIES

J. Martin¹, J. Bosic-Reiniger², K. Brown³, H. Anderson⁴, H. Blackburn⁵, D. Kao⁶, N. McDaniel⁴, K. Trinkley⁶, E. Woodahl³, C. Aquilante⁴; ¹University of Colorado Anschutz Medical Campus, ²University of Montana Skaggs School of Pharmacy, ³University of Montana, ⁴University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, ⁵University of Montana Skaggs School of Pharmacy, Missoula, MT, ⁶University of Colorado School of Medicine.

Background: Clinical decision support (CDS) tools are integral to pharmacogenomic (PGx) care delivery, but their use in resource-constrained settings remains limited. Our objective was to evaluate perspectives about the implementation of PGx CDS tools in rural and underserved settings.

Methods: We developed and administered a 27-question, web-based survey to clinical informaticists, executive leaders, and clinicians in rural and underserved health care settings in Colorado (CO) and Montana (MT). Survey questions were informed by prior qualitative work and included topics such as electronic health record (EHR) characteristics, PGx result EHR integration, and PGx CDS tool build and workflow integration. We descriptively analyzed survey responses.

Results: The survey had 65 respondents (23.4% response rate). Forty-four met the inclusion criteria, i.e., worked in CO or MT and answered >50% of questions, and were included in the final analysis (24 MT, 20 CO). Respondents were primarily from rural or micropolitan areas (59.1%), female (54.5%), and White (90.9%). Respondents reported the following roles: clinical (68.2%), leadership (54.5%), and/or informatics (43.2%). Most respondents (72.7%) agreed/strongly agreed that PGx testing would be clinically useful in their population and 40.9% agreed/strongly agreed that it would be easy to integrate PGx results as structured data in their EHR. However, only 13.6% reported having an institutional clinical PGx testing program. Most participants disagreed/strongly disagreed with the following in relation to their institution: sufficient PGx expertise (61.4%), sufficient financial resources to build/integrate PGx CDS tools (61.4%), sufficient technical/personnel resources to build/integrate PGx CDS tools (59.1%), and sufficient operational priority for PGx CDS tools (52.3%).

Conclusion: Our findings indicate general support for PGx testing and associated CDS tools among respondents from rural and underserved communities. However, several PGx CDS implementation barriers, including resource limitations and competing priorities, were identified, speaking to the need for additional research and innovative strategies to extend the utility and value of CDS-facilitated PGx care delivery to resource-constrained environments.