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Educational Needs of Primary Care Physicians Regarding Direct-to-Consumer Genetic Testing

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

To assess the educational needs of North Carolina primary care physicians (PCPs) about direct-to-consumer (DTC) genetic testing, surveys were mailed to 2,402 family and internal medicine providers in North Carolina. Out of 382 respondents, 323 (85%) felt unprepared to answer patient questions and 282 (74%) reported wanting to learn about DTC genetic testing. A total of 148 (39%) were aware of DTC genetic testing. Among these, 63 (43%) thought DTC genetic testing was clinically useful. PCPs who felt either unprepared to answer patient questions (OR = 0.354, p = 0.01) or that DTC genetic testing was clinically useful (OR = 5.783, p = 0.00) were more likely to want to learn about DTC genetic testing. PCPs are interested in learning about DTC genetic testing, but are mostly unaware of DTC testing and feel unprepared to help patients with DTC testing results. Familiar and trusted channels that provide the information and tools PCPs need to help answer patient’s questions and manage their care should be used when creating educational programs.

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References

  • 2009 by the numbers (2009). Nature medicine, 15(12), 1351–1352.

    Google Scholar 

  • 23andMe (2011). 23andMe terms of service. Retrieved April 12, 2011, from www.23andme.com/legal/tos/

  • American Academy of Family Physicians Core Educational Guidelines: Medical Genetics. (2011). Retrieved September 22, 2010, from www.aafp.org/afp/990700ap/core.html

  • Baars, M. J. H., Scherpbier, A. J. J. A., & Schuwirth, L. W. (2005). Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation. Genetics in Medicine, 7, 295–301.

    Article  PubMed  Google Scholar 

  • Bethea, J., Qureshi, N., Drury, N., & Guilbert, P. (2008). The impact of genetics outreach education and support to primary care on practitioners confidence and competence in dealing with familial cancers. Community Genetics, 11, 289–294.

    Article  PubMed  CAS  Google Scholar 

  • Burke, W. (2004). Genetic testing in primary care. Annual Review of Genomics and Human Genetics, 5, 1–14.

    Article  PubMed  CAS  Google Scholar 

  • Burke, W., & Emery, J. (2002). Genetics education for primary care providers. Nature Reviews, 3, 561–566.

    Article  PubMed  CAS  Google Scholar 

  • Burke, W., Acheson, L., Botkin, J., Bridges, K., Davis, A., Evans, J., et al. (2002). Genetics in primary care: A USA faculty development initiative. Community Genetics, 5, 138–146.

    Article  PubMed  Google Scholar 

  • de Bock, G. H., Vliet Vlieland, T. P., Hageman, G. C., Oosterwijk, J. C., Springer, M. P., & Kievit, J. (1999). The assessment of genetic risk of breast cancer: a set of GP guidelines. Family Practice, 16(1), 71–77.

    Article  PubMed  Google Scholar 

  • deCODEme (2011). deCODEme service agreement. Retrieved April 12, 2011, from www.decodeme.com/service-agreement

  • Dillman, D. A., Smyth, J. D., & Christian, L. M. (2009). Internet, mail and mixed-mode surveys: The tailored design method, 3rd edition. John Wiley & Sons, Inc.

  • Field, A., Krokosky, A., & Terry, S. F. (2010). Direct-to-consumer marketing of genetic tests: access does not reflect clinical utility. Genetic Testing and Molecular Biomarkers, 14(6), 731–732. doi:10.1089/gtmb.2010.1514.

    Article  PubMed  Google Scholar 

  • Feero, W. G. (2005). Peas, priorities, and primary care: cultural competency starts at home. Genetics in Medicine, 7, 588–589.

    Article  PubMed  Google Scholar 

  • Feero, W. G. (2008). Genetics of common disease: a primary care priority aligned with a teachable moment? Genetics in Medicine, 10, 81–82.

    Article  PubMed  Google Scholar 

  • Friedman, L. C., Plon, S. E., Cooper, H. P., & Weinberg, A. D. (1997). Cancer genetics–survey of primary care physicians’ attitudes and practices. Journal of Cancer Education, 12(4), 199–203. doi:10.1080/08858199709528489.

    PubMed  CAS  Google Scholar 

  • Greb, A. E., Brennan, S., McParlane, L., Page, R., & Bridge, P. D. (2009). Retention of medical genetics knowledge and skills by medical students. Genetics in Medicine, 11, 365–370.

    Article  PubMed  Google Scholar 

  • Greendale, K., & Pyeritz, R. E. (2001). Empowering primary care health care professionals in medical genetics: how soon? How fast? American Journal of Medical Genetics, 106, 223–232.

    Article  PubMed  CAS  Google Scholar 

  • Guttmacher, A. E., Jenkins, J. F., & Uhlmann, W. R. (2001). Genomic medicine: who will practice it? A call to open arms. American Journal of Medical Genetics, 106, 216–222.

    Article  PubMed  CAS  Google Scholar 

  • Guttmacher, A. E., Porteous, M. E., & McInerney, J. D. (2007). Educating health-care professionals about genetics and genomics. Nature Reviews, 8, 151–157.

    Article  PubMed  CAS  Google Scholar 

  • Hayflick, S. J., Eiff, M. P., Carpenter, L., & Steinberger, J. (1998). Primary care physicians’ utilization and perceptions of genetics services. Genetics in Medicine, 1(1), 13–21.

    Article  PubMed  CAS  Google Scholar 

  • Hofman, K. J., Tambor, E. S., Chase, G. A., Geller, G., Faden, R. R., & Holtzman, N. A. (1993). Physicians’ knowledge of genetics and genetic tests. Academic Medicine, 68, 625–632.

    Article  PubMed  CAS  Google Scholar 

  • Holtzman, N. A., & Watson, M. S. (1997). Improving providers understanding of genetic testing, Promoting safe and effective genetic testing in the United States: Final Report of the Task Force on Genetic Testing.

  • Kolor, K., Liu, T., St Pierre, J., & Khoury, M. J. (2009). Health care provider and consumer awareness, perceptions and use of direct-to-consumer personal genomic tests, United States, 2008. Genetics in Medicine, 11, 595.

    Article  PubMed  Google Scholar 

  • Laberge, A. M., Fryer-Edwards, K., Kyler, P., Lloyd-Puryear, M. A., & Burke, W. (2009). Long-Term outcomes of the “genetics in primary care” faculty development initiative. Family Medicine, 41, 266–270.

    PubMed  Google Scholar 

  • Ling, Y., Swanson, D. B., Holtzman, K., & Bucak, S. D. (2008). Retention of basic sciences information by senior medical students. Academic Medicine, 83, S82–S85.

    Article  PubMed  Google Scholar 

  • Lydeard, S. (1996). Avoid surveys masquerading as research [commentary]. British Medical Journal, 313, 733–734.

    Article  Google Scholar 

  • McAvoy, B. R., Kaner, E. F. S. (1996). General practice postal surveys: a questionnaire too far? British Medical Journal, 313, 732–733.

    Article  PubMed  CAS  Google Scholar 

  • McGuire, A. L., Diaz, C. M., Wang, T., & Hilsenbeck, S. G. (2009). Social networkers’ attitudes toward direct-to-consumer personal genome testing. The American Journal of Bioethics, 9(6-7), 3-10. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19998099

    Google Scholar 

  • Miller, F. A., Carroll, J. C., Wilson, B. J., Bytautas, J. P., Allanson, J., Cappelli, M., et al. (2010). The primary care physician role in cancer genetics; a qualitative study of patient experience. Family Practice, 27, 563–569.

    Article  PubMed  Google Scholar 

  • Morren, M., Rijken, M., Baanders, A. N., & Bensing, J. (2007). Perceived genetic knowledge, attitudes towards genetic testing, and the relationship between these among patients with a chronic disease. Patient Education and Counseling, 65(2), 197–204.

    Article  PubMed  Google Scholar 

  • Mountcastle-Shah, E., & Holtzman, N. A. (2000). Primary care physicians’ perceptions of barriers to genetic testing and their willingness to participate in research. American Journal of Medical Genetics, 94(5), 409–416. doi:10.1002/1096-8628(20001023)94:5<409::AID-AJMG13>3.0.CO;2-U [pii].

    Article  PubMed  CAS  Google Scholar 

  • National Society of Genetic Counselors (2010). 2010 professional status survey: Work environment retrieved August 8, 2011, from http://www.nsgc.org/MemberCenter/ProfessionalStatusSurveyPSSReports/tabid/253/Default.aspx

  • North Carolina Medical Society (2011). Retrieved April 12, 2011, from http://www.ncmedsoc.org/

  • Offit, K. (2008). Genomic profiles for disease risk: predictive or premature? Journal of the American Medical Association, 299(11), 1353–1355.

    Article  PubMed  CAS  Google Scholar 

  • Ohata, T., Tsuchiya, A., Watanabe, M., Sumida, T., & Takada, F. (2009). Physicians’ opinion for “new” genetic testing in Japan. Journal of Human Genetics, 54, 203–208.

    Article  PubMed  Google Scholar 

  • Pathway Genomics (2011). Pathway genomics terms of service. Retrieved April 1, 2011, from https://www.pathway.com/about-us/terms-of-service

  • Pollack, A. (March 19, 2010). Consumers slow to embrace the age of genomics. The New York Times. Retrieved from http://www.nytimes.com/2010/03/20/business/20consumergene.html?ref=decode-genetics-inc

  • Powell, K. P., Cogswell, W. A., Christianson, C. A., Dave, G., Verma, A., & Henrich, V. C. (2011). Primary care physicians awareness. Experience and Opinions about Direct-to-Consumer Genetic Testing. Journal of Genetic Counseling. doi:DOI 10.1007/s10897-011-9390-9.

  • Reigert-Johnson, D. L., Korf, B. R., Alford, R. L., Broder, M. I., Keats, B. J. B., Ormond, K. E., et al. (2004). Outline of a medical genetics curriculum for internal medicine residency training programs. Genetics in Medicine, 6, 543–547.

    Article  Google Scholar 

  • Report, V. I. (2005). Contemporary issues in medicine: Genetics education. Washington DC: Association of American Medical Colleges.

    Google Scholar 

  • Scheuner, M. T., Sieverding, P., & Shekell, P. G. (2008). Delivery of genomic medicine for common chronic adult diseases. Journal of the American Medical Association, 299, 1320–1334.

    Article  PubMed  CAS  Google Scholar 

  • Suther, S., & Goodson, P. (2003). Barriers to the provision of genetic services by primary care physicians: a systematic review of the literature. Genetics in Medicine, 5, 70–76.

    Article  PubMed  Google Scholar 

  • Swanson, D., Case, S., Leucht, R., & Dillon, G. (1996). Retention of basic science information by fourth-year medical students. Academic Medicine, 71, S80–S82.

    Article  PubMed  CAS  Google Scholar 

  • Thurston, V., Wales, P., Bell, M., Torbeck, L., & Brokaw, J. (2007). The current status of medical genetics instruction in U.S. and Canadian medical schools. Academic Medicine, 82, 441–445.

    Article  PubMed  Google Scholar 

  • US Census Bureau (2009). State median income. Income of households by state: Ranked from highest to lowest using 3-year average (2007–2009). Retrieved from http://www.census.gov/hhes/www/income/statemedfaminc.html

  • US Government Accountability Office (July 22, 2010). Direct-To-Consumer genetic tests: Misleading test results are further complicated by deceptive marketing and other questionable practices. Statement of Gregory Kutz, Managing Director Forensic Audits and Special Investigations Retrieved August 5, 2011, from http://www.gao.gov/products/GAO-10-847T

  • Vence, T. (2010). Docs brace for DTC genomics. Genome Web Retrieved September 14, 2010, from www.genomeweb.com/print/948602

  • Watson, E. K., Shickle, D., Qureshi, N., Emery, J., & Austoker, J. (1999). The ‘new genetics’ and primary care: GPs’ views on their role and their educational needs. Family Practice, 16(4), 420–425.

    Article  PubMed  CAS  Google Scholar 

  • Wright, C. F., & Gregory-Jones, S. (2010). Size of the direct-toconsumer genomic testing market. Genetics in Medicine, 12(9), 594. doi:10.1097/GIM.0b013e3181ead743.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Center for Biotechnology, Genomics & Health Research, The University of North Carolina at Greensboro, PO Box 26170, 1111 Spring Garden Street, Rm. 3708, Greensboro, NC, 27402-6170, USA

    Karen P. Powell, Carol A. Christianson & Vincent C. Henrich

  2. The Genetic Counseling Program, The University of North Carolina at Greensboro, Greensboro, NC, USA

    Whitney A. Cogswell & Sonja Eubanks

  3. Center for Social, Community and Health Research and Evaluation, The University of North Carolina at Greensboro, Greensboro, NC, USA

    Gaurav Dave & Amit Verma

Authors
  1. Karen P. Powell
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  2. Carol A. Christianson
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  3. Whitney A. Cogswell
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  4. Gaurav Dave
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  5. Amit Verma
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  6. Sonja Eubanks
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  7. Vincent C. Henrich
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Corresponding author

Correspondence to Karen P. Powell.

Appendix A: Questions Asking PCPs How They Want to be Educated About DTC Genetic Testing

Appendix A: Questions Asking PCPs How They Want to be Educated About DTC Genetic Testing

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Powell, K.P., Christianson, C.A., Cogswell, W.A. et al. Educational Needs of Primary Care Physicians Regarding Direct-to-Consumer Genetic Testing. J Genet Counsel 21, 469–478 (2012). https://doi.org/10.1007/s10897-011-9471-9

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