Adherence to medication prescriptions can be affected by a range of genetic factors, a European conference has heard.
Researchers at the Molecular Medicine Finland, Helsinki, Finland, told delegates at the European Society of Human Genetics today that although several factors can affect adherence, including behavioural and socioeconomic factors, there have been few investigations into the role played by genetics.
Mattia Cordioli and colleagues examined data from the FinnGen1 study, from Finnish nationwide health registries, and the national drug purchase registry to see if there were any determinants of adherence across different medication groups.
They used information on the date each purchase was made and the quantity purchased to define adherence. They did this by dividing the initial quantity by the number of days, with reference to the prescribed daily dose.
The researchers went on to complete a genome-wide association study (GWAS) to see if genetic variants might help explain variation in adherence.
Mr Cordioli said: “We used these results to see whether we could find a correlation between adherence and other traits that are controlled by multiple genes, rather than just one.
“We found that a positive genetic correlation between adherence and other traits, for example, educational achievement, meant that individuals with a genetic predisposition for higher educational achievement tended to be more adherent.
“On the other hand, those with a genetic predisposition for risk-taking were less adherent to the medication schedule.”
The team also found that a genetic predisposition for higher systolic blood pressure was correlated with increased adherence to blood pressure medication, but there was no such association in patients with such a predisposition for higher LDL (bad) cholesterol and statin adherence.
“This is interesting and may reflect the need for better feedback on the action and efficacy of a particular medication in order to improve adherence,” he added.
“Our research has shown that adherence pertains more to an individual’s predisposition to a particular behaviour rather than to underlying biological factors such as the adverse effects of a particular drug.
“We are hopeful that the identification of those patients who are less likely to adhere to drug therapy may encourage and facilitate the design of effective information campaigns directed at them.”
The conference also heard from legal researchers who warn that the EU’s General Data Protection Regulation (GDPR) has created uncertainty about how key requirements should be interpreted.
Colin Mitchell, senior policy analyst in law, regulation and digital health, and colleagues from the PHG Foundation, University of Cambridge, will tell delegates this means collaborators in international genetic research projects do not always agree on fundamental issues such as if they are processing personal data, consent requirements under the GDPR and on what basis genetic data can be transferred outside the EU/EEA, if at all.
He and his colleagues carried out legal research, interviews, and held an expert meeting to investigate the subject, supported by the UK Information Commissioner’s Office, responsible for national data protection.
Their analysis found that it is possible to come to a range of legal interpretations, and that other parts of the regulation, such as those setting out “data subject rights”, are also potentially ambiguous in the genetic context.
Another problem is how to characterise “personal data” because it is necessary under GDPR to complete a risk assessment to see what sources of information could lead to identification. In the genomic context, finding agreement on this can be particularly challenging. The growth of ancestry websites can complicate things further.
For the UK, Brexit has created additional problems.
Dr Mitchell said: “The UK is now a ‘third country’ and therefore subject to strict rules about receiving data from the EU. Now, the UK’s rules are almost identical to the GDPR. But should they diverge in the future due to changes on either side, this will pose a major problem.”
He said it is possible to follow a more genetics-sensitive approach with the regulators, adding: “And the GDPR also contains some mechanisms that could allow the genomics community to develop best practice for compliance with the regulation and set this out in codes of conduct or certification schemes to demonstrate compliance with the law.
“Developing such a system will not be easy, but it is crucial if confusion about data protection law is not to act as an unwarranted barrier to data sharing and scientific progress in genetics.”
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