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J Genet Couns. 2016 Jun;25(3):472-82. doi: 10.1007/s10897-015-9897-6. Epub 2015 Oct 12.

Patient Perceptions of Telephone vs. In-Person BRCA1/BRCA2 Genetic Counseling.

Author information

1
Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. peshkinb@georgetown.edu.
2
Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA. peshkinb@georgetown.edu.
3
Department of Epidemiology and Biostatistics, George Washington University, Washington, DC, USA.
4
GeneDx, Gaithersburg, MD, USA.
5
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
6
Cancer Genetic Counseling Program, Inova Translational Medicine Institute, Inova Health System, Falls Church, VA, USA.
7
NextGxDx, Inc, Franklin, TN, USA.
8
Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
9
Department of Psychology, Reyjavik University, Reyjavik, Iceland.
10
Department of Clinical Genetics, Risk Assessment Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
11
Department of Medicine, Division of Hematology/Oncology, Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center, Baltimore, MD, USA.
12
Joan H. Marks Graduate Program in Human Genetics, Sarah Lawrence College, Yonkers, NY, USA.
13
Center for Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
14
Familial Cancer Program, University of Vermont Cancer Center, Burlington, VT, USA.
15
Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
16
Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.

Abstract

Telephone genetic counseling (TC) for hereditary breast/ovarian cancer risk has been associated with positive outcomes in high risk women. However, little is known about how patients perceive TC. As part of a randomized trial of TC versus usual care (UC; in-person genetic counseling), we compared high risk women's perceptions of: (1) overall satisfaction with genetic counseling; (2) convenience; (3) attentiveness during the session; (4) counselor effectiveness in providing support; and (5) counselor ability to recognize emotional responses during the session. Among the 554 participants (TC, N = 272; UC, N = 282), delivery mode was not associated with self-reported satisfaction. However, TC participants found counseling significantly more convenient than UC participants (OR = 4.78, 95 % CI = 3.32, 6.89) while also perceiving lower levels of support (OR = 0.56, 95 % CI = 0.40-0.80) and emotional recognition (OR = 0.53, 95 % CI = 0.37-0.76). In exploratory analyses, we found that non-Hispanic white participants reported higher counselor support in UC than in TC (69.4 % vs. 52.8 %; OR = 3.06, 95 % CI = 1.39-6.74), while minority women perceived less support in UC vs. TC (58.3 % vs. 38.7 %; OR = 0.80, 95 % CI = 0.39-1.65). We discuss potential research and practice implications of these findings which may further improve the effectiveness and utilization of TC.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00287898.

KEYWORDS:

BRCA1/BRCA2; Genetic counseling; Patient satisfaction; Telephone counseling

PMID:
26455498
PMCID:
PMC4829475
DOI:
10.1007/s10897-015-9897-6
[Indexed for MEDLINE]
Free PMC Article

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