Randomized Controlled Trial

. 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

Beth N Peshkin^{1

2}, Scott Kelly³, Rachel H Nusbaum⁴, Morgan Similuk⁵, Tiffani A DeMarco⁶, Gillian W Hooker⁷, Heiddis B Valdimarsdottir^{8

9}, Andrea D Forman¹⁰, Jessica Rispoli Joines¹¹, Claire Davis¹², Shelley R McCormick¹³, Wendy McKinnon¹⁴, Kristi D Graves^{15

16}, Claudine Isaacs^{15

16}, Judy Garber¹³, Marie Wood¹⁴, Lina Jandorf⁸, Marc D Schwartz^{15

16}

Affiliations

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.

PMID: 26455498
PMCID: PMC4829475
DOI: 10.1007/s10897-015-9897-6

Randomized Controlled Trial

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

Beth N Peshkin et al. J Genet Couns. 2016 Jun.

. 2016 Jun;25(3):472-82.

doi: 10.1007/s10897-015-9897-6. Epub 2015 Oct 12.

Authors

Affiliations

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.

PMID: 26455498
PMCID: PMC4829475
DOI: 10.1007/s10897-015-9897-6

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.

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Conflict of interest statement

Conflict of Interest: Ms. Peshkin, Mr. Kelly, Ms. Similuk, Ms. DeMarco, Dr. Valdimarsdottir, Ms. Forman, Ms. Rispoli Joines, Ms. Davis, Ms. McKinnon, Dr. Graves, Dr. Isaacs, Dr. Wood, and Ms. Jandorf declare that they have no conflict of interest. Ms. Nusbaum is an employee of GeneDx, but was employed at Georgetown University during all patient accrual and data collection. Dr. Hooker is an employee of NextGxDx, but was employed at Georgetown University during her participation in the study. Ms. McCormick has obtained paid compensation from Myriad Genetics. Dr. Garber has research funding from Myriad Genetics. Dr. Schwartz serves as an uncompensated member of the Scientific Advisory Board for InformedDNA (St. Petersburg, FL).

Figures

**Figure 1**
Figure 1a. Baseline Distress Moderates the Impact of Group on Attentiveness Figure 1b. Race/Ethnicity Moderates the Impact of Group on Perceived Counselor Support

See this image and copyright information in PMC

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

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

Authors

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Abstract

Conflict of interest statement

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