Patient Understanding of Tumor Genomic Testing: A Quality Improvement Effort.

Autor:	Senter L; Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH., Veney D; Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH., Surplus T; School of Communication, Ohio State University, Columbus, OH., Haynam M; Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH., Adams EJ; Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH., Hampel H; Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH.; Division of Clinical Cancer Genomics, Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA., Toland AE; Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH.; Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH., Presley CJ; Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH., Padamsee TJ; Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH., Lee CN; Recruitment, Intervention and Survey Shared Resource, Ohio State University Comprehensive Cancer Center, Columbus, OH., Hovick SR; School of Communication, Ohio State University, Columbus, OH., Stover DG; Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH.; Department of Biomedical Informatics, Ohio State University, Columbus, OH.; Pelotonia Institute for Immuno-Oncology, Ohio State University Comprehensive Cancer, Columbus, OH.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2023 Jan; Vol. 19 (1), pp. e8-e14. Date of Electronic Publication: 2022 Sep 21.
DOI:	10.1200/OP.22.00316
Abstrakt:	Purpose: Tumor genomic testing (TGT) has become increasingly adopted as part of standard cancer care for many cancers. Despite national guidelines around patient education before TGT, available evidence suggests that most patients' understanding of genomics remains limited, particularly lower-income and minority patients, and most patients are not informed regarding potential incidental germline findings. Methods: To investigate and address limitations in patient understanding of TGT results, a Plan-Do-Study-Act (PDSA) approach is being used to assess needs, identify opportunities for improvement, and implement approaches to optimize patient education. We reviewed published guidelines related to pre-TGT provider-patient education and to identify key points (Plan). A provider quality improvement survey was completed (Do), which highlighted inconsistency in pre-TGT discussion practice across providers and minimal discussion with patients regarding the possibility of incidental germline findings. Results: Patient focus groups and interviews (N = 12 patients) were completed with coding of each transcript (Study), which revealed themes including trouble differentiating TGT from other forms of testing, yet understanding that results could tailor therapy. The integration of data across this initial PDSA cycle identified consistent themes and opportunities, which were incorporated into a patient-directed, concise animated video for pre-TGT education (Act), which will form the foundation of a subsequent PDSA cycle. The video addresses how TGT may/may not inform treatment, the process for TGT using existing tissue or liquid biopsy, insurance coverage, and the potential need for germline genetics follow-up because of incidental findings. Conclusion: This PDSA cycle reveals key gaps and opportunities for improvement in patient education before TGT.
Databáze:	MEDLINE
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