Patient and genetic counselor perceptions of in-person versus telephone genetic counseling for hereditary breast/ovarian cancer

Abstract

Telephone genetic counseling (TC) for high-risk women interested in BRCA1/2 testing has been shown to yield positive outcomes comparable to usual care (UC; in-person) genetic counseling. However, little is known about how genetic counselors perceive the delivery of these alternate forms of genetic counseling. As part of a randomized trial of TC versus UC, genetic counselors completed a 5-item genetic counselor process questionnaire (GCQ) assessing key elements of pre-test sessions (information delivery, emotional support, addressing questions and concerns, tailoring of session, and facilitation of decision- making) with the 479 female participants (TC, N=236; UC, N=243). The GCQ scores did not differ for TC vs. UC sessions (t (477) = 0.11, p = 0.910). However, multivariate analysis showed that participant race/ethnicity significantly predicted genetic counselor perceptions (β = 0.172, p<0.001) in that the GCQ scores were lower for minorities in TC and UC. Exploratory analyses suggested that GCQ scores may be associated with patient preference for UC versus TC (t (79) = 2.21, p=0.030). Additionally, we found that genetic counselor ratings of session effectiveness were generally concordant with patient perceptions of the session. These data indicate that genetic counselors perceive that key components of TC can be delivered as effectively as UC, and that these elements may contribute to specific aspects of patient satisfaction. However, undefined process differences may be present which account for lower counselor perceptions about the effectiveness of their sessions with minority women (i.e., those other than non-Hispanic Whites). We discuss other potential clinical and research implications of our findings.

Clinical models of telehealth in genetics: A regional telegenetics landscape

“…Similar to the aforementioned literature regarding live videoconferencing in genetic services, additional previous genetics literature has also outlined various reasons that telephone services may have an important role to play in genetics, including improving access, timeliness, convenience, and efficiency, and reducing costs (Baumanis, Evans, Callanan, & Susswein, ; Peshkin et al, ; Platten et al, ; Sangha, Dircks, & Langlois, ; Schwartz et al, ; Sutphen et al, ). Further, some studies have suggested similar outcomes when comparing telephone consultations to in‐person care (Buchanan et al, ; Chang et al, ; Fournier et al, ; Jacobs et al, ), and to video consultations (Voils et al, ). Some data also suggest that patients prefer, or are willing to utilize, telephone consultations more so than video consultations (Hardy & Grinzaid, ; Voils et al, ).…”

“…As noted in this study, and in some previous work, there is not a one‐size‐fits‐all approach to telegenetics, and each organization must consider its own goals and needs when defining their chosen telegenetics program model within the expanding field of telehealth models. Interestingly, several studies have pointed to the benefits of patients having some choice in how they receive services, citing the potential for improved attendance, satisfaction, and patient outcomes when patients receive their preferred mode of service delivery (Baumanis et al, ; Jacobs et al, ; Hilgart et al, ). Provider engagement is vital to the field in areas such as professional cooperation, telehealth training, and advocacy for telehealth policy.…”

A thematic analysis of health information technology use among cancer genetic counselors

“…Prior studies have found support for related technologies, including telephone genetic counseling and technologies that support family communication. Although these studies did not explicitly include DOI measures, findings suggest that characteristics of the innovation led to positive perceptions of the new innovation among genetic counselors (Greenhalgh et al., 2004; Jacobs et al., 2016).…”

Stay at home: implementation and impact of virtualising cancer genetic services during COVID-19

“…6 7 These alternatives show high rates of patient satisfaction and similar outcomes in measures of knowledge, psychological functioning and uptake of genetic testing compared with in-person appointments. [8][9][10] Thus, the provision of high-quality genetics services through alternate models of care and the virtualisation of clinical systems was seen as an opportunity to maintain genetic counselling services during the COVID-19 pandemic. While some genetic clinics have shown positive adaptations to the pandemic through rapid implementation of well-established alternative service delivery models, there is a paucity of literature describing virtualisation of genetic teams to physically distance within the Canadian context.…”