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Providing patient education: impact on quantity and quality of family health history collection

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Abstract

Background: Family health history (FHH) is an underutilized tool in primary care to identify and risk-stratify individuals with increased cancer risk. Objective: Evaluate the influence of patient education on quantity and quality of FHH entered into a primary care-based software program, and impact on the program’s cancer risk management recommendations. Design: Two primary care practices within a larger type II hybrid implementation-effectiveness controlled clinical trial. Participants: English speaking non-adopted patients with a well visit appointment December 2012–March 2013. Interventions: One to two weeks prior to their well visit appointment, participants entered their FHH into the program. Participants were then provided educational materials describing key FHH components. They were instructed to use the interval to collect additional FHH information. Patients then returned for their scheduled appointment, and updated their FHH with any new information. Main Measures: Percentage per pedigree of relatives meeting individual quality criteria. Changes made after patient education and changes to recommendations for surveillance, chemoprevention or genetic counseling referral. Key Results: Post patient education, pedigrees exhibited a greater percentage (per pedigree) of: deceased relatives with age at death (84 vs. 81 % p = 0.02), deceased relatives with cause of death (91 vs. 87 % p = 0.02), relatives with a named health condition (45 vs. 42 % p = 0.002), and a greater percentage of relatives with high quality records (91 vs. 89 % p = 0.02). Of 43 participants with pedigree changes that could trigger changes in risk stratified prevention recommendations, 12 participants (28 %) received such changes. Conclusions: Patient education improves FHH collection and subsequent risk stratification utilized in providing actionable evidence-based care recommendations for cancer risk management.

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Acknowledgments

The authors received funds from Department of Defense.

Conflict of interest

None.

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Authors and Affiliations

  1. Health Services Research and Development, Durham VA Medical Center, Department of Veteran Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA

    Chris A. Beadles & R. Ryanne Wu

  2. Duke Center for Personalized and Precision Medicine, and Institute of Genome Science and Policy, Duke University Health System, Durham, NC, USA

    Chris A. Beadles, R. Ryanne Wu, Tiffany Himmel, Geoffrey S. Ginsburg & Lori A. Orlando

  3. Duke Department of Internal Medicine, Duke University Health System, Durham, NC, USA

    R. Ryanne Wu & Lori A. Orlando

  4. Duke Cancer Institute, Duke University Health System, Durham, NC, USA

    Adam H. Buchanan

  5. Center for Biotechnology, Genomics and Health Research, UNCG, Greensboro, NC, USA

    Karen P. Powell & Vincent C. Henrich

  6. CSP Epidemiology Center, Department of Veteran Affairs Medical Center, Durham, NC, USA

    Elizabeth Hauser

  7. Center for Human Genetics, Duke University, Durham, NC, USA

    Elizabeth Hauser

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  1. Chris A. Beadles
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Correspondence to Chris A. Beadles.

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Study registry number: NCT 01372553

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Beadles, C.A., Ryanne Wu, R., Himmel, T. et al. Providing patient education: impact on quantity and quality of family health history collection. Familial Cancer 13, 325–332 (2014). https://doi.org/10.1007/s10689-014-9701-z

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  • DOI: https://doi.org/10.1007/s10689-014-9701-z

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