# Understanding barriers and facilitators to pharmacogenomic testing in chronic pain care

> **NIH NIH K99** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $137,218

## Abstract

Project Summary/Abstract
Individual differences in the safety and efficacy of pharmaceuticals are a significant barrier to treatment in pain
medicine, where clinicians must balance safety concerns, particularly around opioids, with the undertreatment
of pain. Pharmacogenomics aims to improve safety and reduce trial-and-error with medications by providing
critical information about an individual’s genetic risk for adverse drug reactions and medication failure.
However, despite institutional support for testing, studies indicate that pharmacogenomic testing is rarely
ordered for pain medication. To improve access to genomic medicine, we need to understand the reason for
this gap, as well as key clinical and ethical considerations to guide patient-centered use. This K99/R00 Award
is a five-year training and research project that will use an exploratory sequential mixed methods design to
improve our understanding of pain physicians’ knowledge, views, and practices with pharmacogenomics.
Physicians impact patient access through their use and interpretation of tests. Board-certified pain physicians
are an understudied group of expert stakeholders who undergo specialized training in the treatment of chronic
pain and the management of medications. Studies have identified system-level educational and administrative
barriers to the use of pharmacogenomics; however, these studies do not account for why some medical
specialties have adopted pharmacogenomic education and testing more quickly than others. Medical
specialties shape physician knowledge, views, and practices through fellowship training, ongoing
professionalization, and clinical guidelines. The specific aims are to 1) Characterize professional discussions in
pain medicine about pharmacogenomics using ethnographic methods. 2) Assess pain physicians’ knowledge,
views, and use of pharmacogenomics using a national survey. 3) Identify a) key barriers and facilitators and b)
clinical and ethical considerations to guide the use of pharmacogenomics in chronic pain care via a synthetic
analysis of ethnographic and quantitative data. The K99 phase of this grant includes a combination of didactic
coursework, directed readings, and clinical immersion to develop the skills and expertise of the candidate in a)
survey design, statistical sampling, and mixed methods analysis, b) pharmacogenomics of pain medications, c)
clinical issues for medication management in chronic pain care, and d) collaborative research and publications.
Through the protected time and mentorship of the proposed Pathway to Independence Award, the candidate
will be able to secure a tenure track position and to fulfill their long-term goal of being an independent scientist
dedicated to examining the ethical, legal, and social implications of the use of genomics in clinical care.

## Key facts

- **NIH application ID:** 10865760
- **Project number:** 1K99HG013600-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Katherine Marie Hendy
- **Activity code:** K99 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $137,218
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865760

## Citation

> US National Institutes of Health, RePORTER application 10865760, Understanding barriers and facilitators to pharmacogenomic testing in chronic pain care (1K99HG013600-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10865760. Licensed CC0.

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