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Delivering genomic medicine in the UK National Health Service: a systematic review and narrative synthesis

Lookup NU author(s): Dr Nina Hallowell, Dr Pauline McCormack

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Nature Publishing Group, 2019.

For re-use rights please refer to the publisher's terms and conditions.


Abstract

Purpose We sought to assess the readiness of the United Kingdom National Health Service to implement a Genomic Medicine Service. We conducted a systematic literature review aimed to identify what is known about factors related to the implementation of genomic medicine in routine health care and to draw out the implications for the UK and other settings. Methods Relevant studies were identified in Web of Science and PubMed from their date of inception to April 2018. The review included primary research studies using quantitative, qualitative or mixed methods, and systematic reviews. A narrative synthesis was conducted. Results Fifty-five studies met our inclusion criteria. The majority of studies reviewed were conducted in the US. We identified four domains: 1) systems; 2) training and workforce needs; 3) professional attitudes and values; and 4) the role of patients and the public. Conclusion Mainstreaming genomic medicine into routine clinical practice requires actions at each level of the health care system. Our synthesis emphasised the organisational, social and cultural implications of reforming practice, highlighting that demonstration of clinical utility and cost effectiveness, attending to the compatibility of genomic medicine with clinical principles and involving and engaging patients are key to successful implementation.


Publication metadata

Author(s): Pearce C, Goettke E, Hallowell N, McCormack P, Flinter F, McKevitt C

Publication type: Article

Publication status: Published

Journal: Genetics in Medicine

Year: 2019

Volume: 21

Pages: 2667-2675

Online publication date: 12/06/2019

Acceptance date: 30/05/2019

Date deposited: 30/05/2019

ISSN (print): 1098-3600

ISSN (electronic): 1530-0366

Publisher: Nature Publishing Group

URL: https://doi.org/10.1038/s41436-019-0579-x

DOI: 10.1038/s41436-019-0579-x


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