Genetic literacy among primary care physicians in a resource-constrained setting

Abstract

Background: Genetic literacy among primary healthcare providers is crucial for appropriate patient care with the advances in genetic and genomic medicine. Studies from high-income countries highlight the lack of knowledge in genetics and the need to develop curricula for continuing professional development of non-geneticists. Scarce data is available from resource-constrained countries in Middle East and North Africa. Lebanon is a small country in this region characterized by high rates of consanguinity and genetic disorders like several surrounding countries, such as Jordan, Syria, and Turkey.

Methods: The primary aim of this study assessed the genetic literacy, self-perceived and actual knowledge as well as practices among primary care providers in Lebanon. The secondary aim identified their educational needs and proposed evidence-based continuing education programs. A cross-sectional survey-based study, using a self-administered questionnaire, was conducted targeting physicians from Family Medicine, Obstetrics and Gynecology, and Pediatrics. The questionnaire was divided into five sections: demographics, familiarity with genetic tests, self-reported and actual knowledge, genetic practices, and educational needs. Statistics were performed using SPSS v24. The Chi-square test was used for independent variables. Differences between mean scores were measured using paired sample t-tests for groups of two levels and one-way ANOVA for more than two. Multiple linear regression was used to study the variables associated with the knowledge score while controlling for other variables.

Results: The survey included 123 physicians. They were mostly familiar with karyotype as first-tier genetic test. Although 38% perceived their knowledge as good, only 6% scored as such in knowledge assessment. A better knowledge score was observed in academic institutions as well as in urban settings (p<0.05). One third never ordered any genetic testing, mostly due to poor knowledge. Almost all (98%) were ready to attend continuing professional development sessions in genetics.

Conclusion: Our findings show the need to improve genetic literacy among healthcare frontliners, focusing on remote regions and nonacademic centers in Lebanon, a model for other resource-constrained country in the Middle East and North Africa region. This study advances recommendations for evidence-based genetic continuing education programs and highlighted the role of that the few genetic specialists can play in their successful implementation.

Keywords: Continuing education; Genetics; Health literacy; Healthcare practice; Knowledge; Primary care.

Fig. 1

Distribution of physicians by specialty. (Abbreviations: FM: Family Medicine, OBGYN: Obstetrics and Gynecology, PED: Pediatrics and Adolescent Medicine)

Fig. 2

Distribution of surveyed physicians among healthcare sectors

Fig. 3

Familiarity of primary care providers with genetic tests and techniques. (Scoring from 1 to 10: from lowest to highest familiarity)

Fig. 4

Self-rated and assessed genetic knowledge of 123 primary care providers

Fig. 5

Average score of genetic knowledge scopes among 123 primary care providers (a: Basic genetic knowledge, b: able to recognize a genetic syndrome, c: knowledge of appropriate genetic testing, d: knowledge of appropriate plan of care)