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Assessment of clinical practices among cancer genetic counselors

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Abstract

Various models of cancer genetics service delivery have been published, and practice guidelines were set forth by the National Society of Genetic Counselors (NSGC) in 2004. While the demand for services has increased, there has not been a comprehensive study of current practice models. An online survey of the NSGC Familial Cancer Risk Counseling Special Interest Group was conducted to study current methods of providing clinical cancer genetics services. Respondents were asked to quantify patient volume, support staff availability, and physician involvement in cases. Two case examples were used to further describe current practices including the number of genetic counseling tasks performed, time spent in these tasks, and number of in-person visits versus phone encounters. Although published cancer genetic counseling guidelines advise a 3-visit model (initial consult, sample draw, and result disclosure), 29.3% of respondents have adopted a 1-visit model, where the sample is drawn at the first visit and phone disclosure replaces the third visit. The content of the initial consult does not vary significantly, and is consistent with the NSGC practice guidelines. Furthermore, 56% report spending >15 min on case preparation, and 27 respondents self-reported redundancy in tasks such as documentation. It appears that a proportion of genetic counselors are following a new model of service delivery. However, insufficient documentation and case preparation are apparent, and many respondents reported lack of support staff as a barrier to efficient patient care. Factors contributing to the variability in current practice, and how they affect efficiency, require further study.

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Abbreviations

NSGC:

National society of genetic counselors

NSGC Cancer SIG:

National society of genetic counselors familial risk cancer counseling special interest group

References

  1. Biesecker BB, Boehnke M et al (1993) Genetic counseling for families with inherited susceptibility to breast and ovarian cancer. JAMA 269(15):1970–1974

    Article  CAS  PubMed  Google Scholar 

  2. International Huntington Association and the World Federation of Neurology Research Group on Huntington’s Chorea (1994) Guidelines for the molecular genetics predictive test in Huntington’s disease. Neurology 44(8):1533–1536

    Google Scholar 

  3. International Huntington Association and the World Federation of Neurology Research Group on Huntington’s Chorea (1994) Guidelines for the molecular genetics predictive test in Huntington’s disease. J Med Genet 31(7):555–559

    Article  Google Scholar 

  4. Brain K, Sivell S et al (2005) An exploratory comparison of genetic counselling protocols for HNPCC predictive testing. Clin Genet 68(3):255–261

    Article  CAS  PubMed  Google Scholar 

  5. American Society of Clinical Oncology (2003) American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility. J Clin Oncol 21(12):2397–2406

    Article  Google Scholar 

  6. Khatcheressian JL, Wolff AC et al (2006) American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 24(31):5091–5097

    Article  PubMed  Google Scholar 

  7. Lancaster JM, Powell CB et al (2007) Society of Gynecologic Oncologists Education Committee statement on risk assessment for inherited gynecologic cancer predispositions. Gynecol Oncol 107(2):159–162

    Article  PubMed  Google Scholar 

  8. Murphy CD, Lee JM et al (2008) The American Cancer Society guidelines for breast screening with magnetic resonance imaging: an argument for genetic testing. Cancer 113(11):3116–3120

    Article  PubMed  Google Scholar 

  9. Winawer S, Fletcher R et al (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence. Gastroenterology 124(2):544–560

    Article  PubMed  Google Scholar 

  10. Trepanier A, Ahrens M et al (2004) Genetic cancer risk assessment and counseling: recommendations of the national society of genetic counselors. J Genet Couns 13(2):83–114

    Article  PubMed  Google Scholar 

  11. Bernhardt BA, Tumpson JE, Pyeritz RE (1992) The economics of clinical genetics services. IV. Financial impact of outpatient genetic services on an academic institution. Am J Hum Genet 50(1):84–91

    CAS  PubMed  Google Scholar 

  12. Bernhardt BA, Weiner J et al (1987) The economics of clinical genetics services. II. A time analysis of a medical genetics clinic. Am J Hum Genet 41(4):559–565

    CAS  PubMed  Google Scholar 

  13. Cooksey JA, Forte G et al (2006) The medical genetics workforce: an analysis of clinical geneticist subgroups. Genet Med 8(10):603–614

    Article  PubMed  Google Scholar 

  14. Schneider K (2002) Counseling about cancer, 2nd edn. Wiley-Liss, Inc., New York City

    Google Scholar 

  15. McPherson E, Zaleski C et al (2008) Clinical genetics provider real-time workflow study. Genet Med 10(9):699–706

    Article  PubMed  Google Scholar 

  16. Kausmeyer DT, Lengerich EJ et al (2006) A survey of patients’ experiences with the cancer genetic counseling process: recommendations for cancer genetics programs. J Genet Couns 15(6):409–431

    Article  PubMed  Google Scholar 

  17. Stopfer JE (2000) Genetic counseling and clinical cancer genetics services. Semin Surg Oncol 18(4):347–357

    Article  CAS  PubMed  Google Scholar 

  18. Armel SR, McCuaig J et al (2009) The effectiveness of family history questionnaires in cancer genetic counseling. J Genet Couns 18(4):366–378

    Article  PubMed  Google Scholar 

  19. Jenkins J, Calzone KA et al (2007) Randomized comparison of phone versus in-person BRCA1/2 predisposition genetic test result disclosure counseling. Genet Med 9(8):487–495

    Article  PubMed  Google Scholar 

  20. Baumanis L, Evans JP et al (2009) Telephoned BRCA1/2 genetic test results: prevalence, practice, and patient satisfaction. J Genet Couns 18(5):447–463

    Article  CAS  PubMed  Google Scholar 

  21. Baker D, Eash T et al (2002) Guidelines for writing letters to patients. J Genet Counsel 11(5):399–418

    Article  Google Scholar 

  22. Irons M (2008) The genetics clinic: where does the time go? Genet Med 10(9):657–658

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the NSGC Familial Cancer Risk Counseling Special Interest Group Grant Award. The authors would like to thank Dawn Allain and Sarah Coombes for their contribution to the pilot study.

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Correspondence to Deborah Wham.

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Wham, D., Vu, T., Chan-Smutko, G. et al. Assessment of clinical practices among cancer genetic counselors. Familial Cancer 9, 459–468 (2010). https://doi.org/10.1007/s10689-010-9326-9

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  • DOI: https://doi.org/10.1007/s10689-010-9326-9

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