Patients' and professionals' perspective of non-in-person visits in hereditary cancer: predictors and impact of the COVID-19 pandemic

Abstract

Purpose: To identify predictors of patient acceptance of non-in-person cancer genetic visits before and after the COVID-19 pandemic and assess the preferences of health-care professionals.

Methods: Prospective multicenter cohort study (N = 578, 1 February 2018-20 April 2019) and recontacted during the COVID-19 lockdown in April 2020. Health-care professionals participated in May 2020. Association of personality traits and clinical factors with acceptance was assessed with multivariate analysis.

Results: Before COVID-19, videoconference was more accepted than telephone-based visits (28% vs. 16% pretest, 30% vs. 19% post-test). Predictors for telephone visits were age (pretest, odds ratio [OR] 10-year increment = 0.79; post-test OR 10Y = 0.78); disclosure of panel testing (OR = 0.60), positive results (OR = 0.52), low conscientiousness group (OR = 2.87), and post-test level of uncertainty (OR = 0.93). Predictors for videoconference were age (pretest, OR 10Y = 0.73; post-test, OR 10Y = 0.75), educational level (pretest: OR = 1.61), low neuroticism (pretest, OR = 1.72), and post-test level of uncertainty (OR = 0.96). Patients' reported acceptance for non-in-person visits after COVID-19 increased to 92% for the pretest and 85% for the post-test. Health-care professionals only preferred non-in-person visits for disclosure of negative results (83%).

Conclusion: These new delivery models need to recognize challenges associated with age and the psychological characteristics of the population and embrace health-care professionals' preferences.

Fig. 1

Evolution of patients’ reported acceptance of non-in-person visits before and after the lockdown caused by COVID-19. Acceptors (dark), decliners (light) of non-in-person visits.

Fig. 2

Univariate and multivariate analyses of predictors of reported acceptance to pretest and result disclosure telephone-based visits, before the COVID-19 pandemic (N = 578). a pretest and b result disclosure telephone-based visits. The percentage of acceptance with 95% CI is plotted for each variable. Odds ratio with 95% CI and p-values were calculated using the logistic model. PV pathogenic variant.

Fig. 3

Univariate and multivariate analyses of predictors of reported acceptance to pretest and result disclosure videoconference-based visits, before the COVID-19 pandemic (N = 578). a pretest and b result disclosure videoconference-based visits. The percentage of acceptance with 95% CI is plotted for each variable. Odds ratio with 95% CI and p-values were calculated using the logistic model. PV pathogenic variant.