Knowledge Translation of Pharmacogenomics for Pain Management in Patients With Sickle Cell Disease—A Qualitative Study

BACKGROUND: Health care providers (HCPs) currently prescribe analgesics based on clinical experience, placing Black Americans with sickle cell disease (SCD) at risk for poorly controlled pain, adverse drug effects, and bias. Pharmacogenomics could guide individualized pain management, but many HCPs feel unprepared to use this information in practice. OBJECTIVE: This qualitative research study explored the needs of pediatric hematology HCPs to integrate pharmacogenomics into care for SCD. DESIGN/SETTING: Semistructured interviews and focus groups were conducted at a large urban quaternary-care hospital using a constructivist grounded theory approach to identify knowledge and implementation needs. PARTICIPANTS: Physicians and nurse practitioners in the department of hematology/oncology, and registered nurses providing inpatient care for patients with SCD in vaso-occlusive crisis were recruited for interviews. RESULTS: Three major themes emerged from the study: (1) a perceived lack of knowledge about pharmacogenomics; (2) challenges in controlling pain; and (3) functionality of the electronic medical record (EMR). CONCLUSION: HCPs feel unprepared to use pharmacogenomic data to manage pain experienced by patients with SCD. Continuing education and point-of-care tools are needed to translate pharmacogenetic data into clinical practice. The EMR is essential for bridging the knowledge-to-practice gap and advancing precision pain management for people with SCD.