Overviews of reviews e questionário aplicado aos estudantes de medicina sobre a temática farmacogenética
Data
2024-06-26
Autores
Lara, Danilo Vieira de 
Orientadores
Santos, Paulo Caleb Júnior de Lima
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Conduzimos overviews of reviews sobre o uso de testes farmacogenéticos para as áreas de oncologia, cardiologia, hematologia, psiquiatria e neurologia, baseando-nos em pares fármaco-gene clinicamente relevantes; além disso, avaliamos o conhecimento de estudantes de medicina de universidades públicas brasileiras, por meio de questionário, sobre a área da farmacogenética e a interpretação de testes farmacogenéticos. Métodos: Realizamos uma busca no Medline, Embase e Biblioteca Cochrane. O instrumento de pesquisa foi um questionário de 16 questões com base nos padronizados da literatura. Houve atribuição de pontuações de questões automaticamente após o participante enviar o formulário. A análise estatística foi realizada utilizando o software SPSS 25.0, com significância definida em valores de p inferiores a 0.05. Resultados: Selecionamos quarenta e três revisões sistemáticas. Os pares fármaco-gene mais estudados foram, para a Oncologia: tamoxifeno – CYP2D6; fluorouracil – DPYD; Cardiologia: clopidogrel – CYP2C19; Hematologia: varfarina – CYP2C9, VKORC1; Neurologia: carbamazepina – HLA-A, HLA-B; oxcarbazepina – HLA-B; fenitoína – CYP2C9; e Psiquiatria: citalopram/escitalopram – CYP2C19; paroxetina – CYP2D6. Porém, diversas revisões foram classificadas como “qualidade criticamente baixa” ou “qualidade baixa”. Cento e um estudantes de graduação em medicina, voluntários (47 homens; 53 mulheres e 1 não especificado), forneceram seu consentimento informado e foram incluídos no estudo. A média de idade foi de 25,3±5,3 anos. A média de pontuação geral dos estudantes, independentemente do ano curricular de graduação matriculado, foi 1.9±0.9 (46.8%) de 4.0 (100%) pontos avaliados nas quatro questões de conhecimento do questionário. Conclusões: Há necessidade de mais revisões sistemáticas de alta qualidade, que avaliem o risco de viés, com definições consistentes de resultados clínicos para considerar os benefícios dos testes farmacogenéticos. Os estudantes de medicina souberam definir o conceito de farmacogenética, concordaram que é importante para a prática clínica deles, porém há necessidade de mais desenvolvimento do conhecimento sobre o uso e a interpretação dos testes farmacogenéticos.
Objective: We conduct overviews of reviews on the use of pharmacogenetic tests for the áreas of oncology, cardiology, hematology, psychiatry and neurology, based on clinically relevant druggene pairs; furthermore, we assessed the knowledge of medical students from Brazilian public universities, through a questionnaire, on the area of pharmacogenetics and the interpretation of pharmacogenetic tests. Methods: We searched Medline, Embase and the Cochrane Library. The research instrument was a 16question questionnaire based on standards in the literature. Question scores were assigned automatically after the participant submitted the form. Statistical analysis was performed using SPSS 25.0 software, with significance defined at p values below 0.05. Results: We selected fortythree systematic reviews. The most studied druggene pairs were, for Oncology: tamoxifen – CYP2D6; fluorouracil – DPYD; Cardiology: clopidogrel – CYP2C19; Hematology: warfarin – CYP2C9, VKORC1; Neurology: carbamazepine – HLAA, HLAB; oxcarbazepine – HLAB; phenytoin – CYP2C9; and Psychiatry: citalopram/escitalopram – CYP2C19; paroxetine – CYP2D6. However, several reviews were classified as “critically low quality” or “low quality”. One hundred and one undergraduate medical student volunteers (47 men; 53 women and 1 unspecified) provided informed consent and were included in the study. The average age was 25.3±5.3 years. The students' overall average score, regardless of the undergraduate year enrolled, was 1.9±0.9 (46.8%) out of 4.0 (100%) points assessed in the 4 knowledge questions of the questionnaire. Conclusions: There is a need for more highquality systematic reviews that assess the risk of bias, with consistent definitions of clinical outcomes to consider the benefits of pharmacogenetic testing. Medical students knew how to define the concept of pharmacogenetics and agreed that it is important for their clinical practice, but there is a need for further development of knowledge about the use and interpretation of pharmacogenetic tests.
Objective: We conduct overviews of reviews on the use of pharmacogenetic tests for the áreas of oncology, cardiology, hematology, psychiatry and neurology, based on clinically relevant druggene pairs; furthermore, we assessed the knowledge of medical students from Brazilian public universities, through a questionnaire, on the area of pharmacogenetics and the interpretation of pharmacogenetic tests. Methods: We searched Medline, Embase and the Cochrane Library. The research instrument was a 16question questionnaire based on standards in the literature. Question scores were assigned automatically after the participant submitted the form. Statistical analysis was performed using SPSS 25.0 software, with significance defined at p values below 0.05. Results: We selected fortythree systematic reviews. The most studied druggene pairs were, for Oncology: tamoxifen – CYP2D6; fluorouracil – DPYD; Cardiology: clopidogrel – CYP2C19; Hematology: warfarin – CYP2C9, VKORC1; Neurology: carbamazepine – HLAA, HLAB; oxcarbazepine – HLAB; phenytoin – CYP2C9; and Psychiatry: citalopram/escitalopram – CYP2C19; paroxetine – CYP2D6. However, several reviews were classified as “critically low quality” or “low quality”. One hundred and one undergraduate medical student volunteers (47 men; 53 women and 1 unspecified) provided informed consent and were included in the study. The average age was 25.3±5.3 years. The students' overall average score, regardless of the undergraduate year enrolled, was 1.9±0.9 (46.8%) out of 4.0 (100%) points assessed in the 4 knowledge questions of the questionnaire. Conclusions: There is a need for more highquality systematic reviews that assess the risk of bias, with consistent definitions of clinical outcomes to consider the benefits of pharmacogenetic testing. Medical students knew how to define the concept of pharmacogenetics and agreed that it is important for their clinical practice, but there is a need for further development of knowledge about the use and interpretation of pharmacogenetic tests.
Descrição
Citação
LARA, Danilo Vieira de. Overviews of reviews e questionário aplicado aos estudantes de medicina sobre a temática farmacogenética. 2024. 71 f. Tese (Doutorado em Famacologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.