Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems.

Autor: Bednar EM; The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America. Electronic address: embednar@mdanderson.org., Chen M; The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America., Walsh MT Jr; The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America., Eppolito AL; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Klein MH; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Teed K; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Hodge B; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Hunter J; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Chao HG; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Davis D; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Serchion W; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Yobbi C; Community Health Network, Indianapolis, IN, United States of America., Krukenberg R; Community Health Network, Indianapolis, IN, United States of America., Jenkinson SB; Community Health Network, Indianapolis, IN, United States of America., Moore JJ; Community Health Network, Indianapolis, IN, United States of America., Garcia C; Community Health Network, Indianapolis, IN, United States of America., Gonzalez F; Community Health Network, Indianapolis, IN, United States of America., Murray T; Community Health Network, Indianapolis, IN, United States of America., Nielsen LD; Community Health Network, Indianapolis, IN, United States of America., Ho B; Community Health Network, Indianapolis, IN, United States of America., Haas M; Community Health Network, Indianapolis, IN, United States of America., Greenzweig SB; Community Health Network, Indianapolis, IN, United States of America., Anderson A; Community Health Network, Indianapolis, IN, United States of America., Johnson C; Community Health Network, Indianapolis, IN, United States of America., Morman NA; OhioHealth, Columbus, OH, United States of America., Bowdish E; OhioHealth, Columbus, OH, United States of America., Wise E; OhioHealth, Columbus, OH, United States of America., Cooper JN; OhioHealth, Columbus, OH, United States of America., Russ PK; OhioHealth, Columbus, OH, United States of America., Tondo-Steele K; OhioHealth, Columbus, OH, United States of America., de Gracia BF; OhioHealth, Columbus, OH, United States of America., Levin B; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Mattie K; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Zarnawski K; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Kalasinski M; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Stone J; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., O'Brien C; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Bream A; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Kennedy AM; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Paul RA; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Bilbao M; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Romero M; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Carr RL; Banner MD Anderson Cancer Center, Gilbert, AZ, United States of America., Siettmann JM; Banner MD Anderson Cancer Center, Gilbert, AZ, United States of America., Vercruyssen AK; Banner MD Anderson Cancer Center, Gilbert, AZ, United States of America., Leon K; Banner MD Anderson Cancer Center, Gilbert, AZ, United States of America., Arun BK; The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America., Grainger AV; OhioHealth, Columbus, OH, United States of America., Warshal DP; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Bowman E; Piedmont Oncology at Piedmont Healthcare, Atlanta, GA, United States of America., Goedde TA; Community Health Network, Indianapolis, IN, United States of America., Halaharvi D; OhioHealth, Columbus, OH, United States of America., Rath K; OhioHealth, Columbus, OH, United States of America., Grana G; MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, United States of America., Mina L; Banner MD Anderson Cancer Center, Gilbert, AZ, United States of America., Lu KH; The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2023 May; Vol. 172, pp. 106-114. Date of Electronic Publication: 2023 Mar 31.
DOI: 10.1016/j.ygyno.2023.03.016
Abstrakt: Objective: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).
Methods: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, chi-squared/Fisher's exact test, and logistic regression.
Results: For patients with OC, improvement was observed in the rate of referral (from 70% to 79%), GC (from 44% to 61%), GT (from 54% to 62%) and decreased time from diagnosis to GC and GT. For patients with TNBC, increased rates of referral (from 90% to 92%), GC (from 68% to 72%) and GT (81% to 86%) were observed. Effective interventions streamlined GC scheduling and standardized referral processes.
Conclusion: A multi-year QII increased patient referral and uptake of recommended genetics services across five unique community-based oncology care settings.
Competing Interests: Declaration of Competing Interest The following authors report no conflict of interest: Erica M. Bednar, Minxing Chen, Michael T. Walsh, Jr., Amanda L. Eppolito, Molly H. Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Sandra B. Jenkinson, Jennifer J. Moore, Cassandra Garcia, Christina Johnson, Fatimaeliza Gonzalez, Towanna Murray, Linda D. Nielsen, Brenda Ho, Megan Haas, Sarah B. Greenzweig, Abby Anderson, Nichole A. Morman, Elizabeth Bowdish, Emaline Wise, Julia N. Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F. de Gracia, Brooke Levin, Kristin Mattie, Molly Kalasinski, Kathryn Zarnawski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M. Kennedy, Rachel A. Paul, Michelle Bilbao, Maureen Romero, Anna K. Vercruyssen, Kaycee Leon, Banu K. Arun, Andrew V. Grainger, David P. Warshal, Erin Bowman, Timothy A. Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H. Lu. The following authors disclose potential conflicts of interest: Han Gill Chao is an employee at Fulgent Genetics and received restricted stock units as part of compensation, and Rebecca L. Carr is a full-time salaried employee of Ambry Genetics however, Han Gill Chao and Rebecca L. Carr were not employed by these organizations during their participation in the study. Rebekah Krukenberg received payment from Ambry Genetics for educational speaking opportunities and reimbursement of travel to educational speaking events. Jennifer Siettmann holds an unpaid, elected leadership position with Arizona Genetics Alliance.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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