Aim: To identify implementation determinants and examine healthcare professional (HCP) and consumer perspectives on pharmacogenomics (PGx) in oncology using Theoretical Domains Framework (TDF)-informed surveys assessing knowledge, attitudes, perceptions, practices, barriers, education needs, and delivery preferences across Australia.
Methods: National surveys were distributed between February and December 2024 through a PGx trial network, professional organisations, and consumer advocacy groups. The HCP survey targeted doctors, nurses, and pharmacists involved in cancer care, while the consumer survey targeted adults affected by cancer and carers.
Results: A total of 224 responses were received, including 118 HCPs and 106 consumers, with broad representation from metropolitan (52%) and regional (48%) Australia. Support for PGx implementation was high among both HCPs and consumers, with similar endorsement of access to testing (90% and 91%, respectively). Following brief education, consumers were more likely than HCPs to support universal PGx testing in oncology care (95% vs 73%). Despite 81% of HCPs reporting moderate-to-high PGx knowledge, only 31% felt confident applying PGx in clinical practice. Financial burden (86%) and limited infrastructure (67%) were the most significant implementation barriers. HCPs considered inclusion of PGx recommendations within oncology clinical guidelines a stronger implementation enabler than PGx-specific guidance alone (70% vs 30%). Differences emerged regarding PGx service delivery. HCPs were more supportive of sharing PGx results with general practitioners (95% vs 82%) and community pharmacists (80% vs 55%), whereas consumers preferred PGx discussions primarily with doctors (60%) rather than pharmacists (14%), genetic counsellors (15%), or nurses (10%).
Conclusions: Although HCPs and consumers strongly support integration of PGx into oncology care, gaps remain in HCP preparedness and healthcare infrastructure. Differences in expectations regarding responsibility for PGx discussions and access to results represent an under-recognised implementation challenge. Embedding PGx within existing oncology care pathways and clinical guidelines, alongside targeted workforce education, may support sustainable, patient-centred implementation.