Patient reactions to personalized medicine vignettes: An experimental design

Morgan Butrick, Debra Roter, Kimberly Kaphingst, Lori H. Erby, Carlton Haywood, Mary Catherine Beach, Howard P. Levy

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


PURPOSE: Translational investigation on personalized medicine is in its infancy. Exploratory studies reveal attitudinal barriers to "race-based medicine" and cautious optimism regarding genetically personalized medicine. This study describes patient responses to hypothetical conventional, race-based, or genetically personalized medicine prescriptions. METHODS: Three hundred eighty-seven participants (mean age = 47 years; 46% white) recruited from a Baltimore outpatient center were randomized to this vignette-based experimental study. They were asked to imagine a doctor diagnosing a condition and prescribing them one of three medications. The outcomes are emotional response to vignette, belief in vignette medication efficacy, experience of respect, trust in the vignette physician, and adherence intention. RESULTS: Race-based medicine vignettes were appraised more negatively than conventional vignettes across the board (Cohen's d = -0.51-0.57-0.64, P < 0.001). Participants rated genetically personalized comparably with conventional medicine (-0.14-0.15-0.17, P = 0.47), with the exception of reduced adherence intention to genetically personalized medicine (Cohen's d = -0.38-0.41-0.44, P = 0.009). This relative reluctance to take genetically personalized medicine was pronounced for racial minorities (Cohen's d = -0.38-0.31-0.25, P = 0.02) and was related to trust in the vignette physician (change in R2 = 0.23, P < 0.001). CONCLUSIONS: This study demonstrates a relative reluctance to embrace personalized medicine technology, especially among racial minorities, and highlights enhancement of adherence through improved doctor-patient relationships.

Original languageEnglish (US)
Pages (from-to)421-428
Number of pages8
JournalGenetics in Medicine
Issue number5
StatePublished - May 2011


  • clinical vignette
  • doctor-patient relationship
  • genetics
  • personalized medicine
  • race and ethnicity

ASJC Scopus subject areas

  • Genetics(clinical)


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