A Comprehensive Program Enabling Effective Delivery of Regional Genetic Counseling
| Autor: | Jubilee Brown, L. Amacker-North, Aly Athens, David L. Tait, R. Wendel Naumann, Erin K. Crane, Robert V. Higgins, Lejla Hadzikadic Gusic |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Telemedicine medicine.medical_specialty Referral Genetic counseling Breast Neoplasms Genetic Counseling 030105 genetics & heredity Regional Medical Programs 03 medical and health sciences symbols.namesake 0302 clinical medicine Breast cancer Health care medicine Humans Patient Navigation Fisher's exact test Ovarian Neoplasms business.industry Obstetrics and Gynecology medicine.disease Cancer registry Oncology 030220 oncology & carcinogenesis Family medicine symbols Female Ovarian cancer business |
| Zdroj: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 28(5) |
| ISSN: | 1525-1438 |
| Popis: | ObjectivesThe aim of this study was to demonstrate the utility of a comprehensive program involving management-based evidence, telemedicine, and patient navigation to provide genetic counseling services for patients with ovarian and breast cancer across a geographically large health care system.MethodsWe identified all patients with newly diagnosed ovarian and breast cancer in our health care system from January 2013 to December 2015 through the cancer registry. Referral characteristics and testing outcomes were recorded for each year and compared using the χ2 or Fisher exact test.ResultsBecause the implementation of this program, the number of new ovarian cancer cases remained constant (109–112 cases/year) but patients referred for genetic counseling increased annually from 37% to 43% to 96% (P < 0.05). The percentage of ovarian cancer patients who underwent genetic testing increased annually from 24% to 27% to 53% (P < 0.05). The number of new breast cancer patients was constant (1543–1638 cases/year). The percentage of patients with triple negative breast cancer referred for genetic counseling rose from 69% in 2013 to 91% in 2015; the percentage of patients who underwent testing increased annually from 59% to 86% (P < 0.05). Of women with breast cancer diagnosed at less than 45 years of age, 78% to 85% were referred for genetic counseling across this period; the percentage of patients who underwent testing increased annually from 66% to 82% (P < 0.05). Patient navigation was initiated and was available to all patients in the system during this period. Telemedicine consults were performed in 118 breast/ovarian patients (6%) during this period.ConclusionsA comprehensive program may improve access to effective genetic counseling services in patients with ovarian and breast cancer despite geographic barriers. |
| Databáze: | OpenAIRE |
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