1
|
Ong CSB, Fok RW, Tan RCA, Fung SM, Sun S, Ngeow JYY. General practitioners' (GPs) experience, attitudes and needs on clinical genetic services: a systematic review. Fam Med Community Health 2022; 10:fmch-2021-001515. [PMID: 36450397 PMCID: PMC9717000 DOI: 10.1136/fmch-2021-001515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE The proliferation and growing demands of genetic testing are anticipated to revolutionise medical practice. As gatekeepers of healthcare systems, general practitioners (GPs) are expected to play a critical role in the provision of clinical genetic services. This paper aims to review existing literature on GPs' experience, attitudes and needs towards clinical genetic services. DESIGN A systematic mixed studies review of papers published between 2010 and 2022. ELIGIBILITY CRITERIA The inclusion criterion was peer-reviewed articles in English and related to GPs' experience, views and needs on any genetic testing. INFORMATION SOURCES The PubMed, PsycINFO, Cochrane, EMBASE databases were searched using Mesh terms, Boolean and wildcards combinations to identify peer-reviewed articles published from 2010 to 2022. Study quality was assessed using Mixed Methods Appraisal Tool. Only articles that fulfilled the inclusion criteria were selected. A thematic meta-synthesis was conducted on the final sample of selected articles to identify key themes. RESULTS A total of 62 articles were included in the review. Uncertainty over GPs' role in providing genetic services were attributed by the lack of confidence and time constraints and rarity of cases may further exacerbate their reluctance to shoulder an expanded role in clinical genetics. Although educational interventions were found to increasing GPs' knowledge and confidence to carry out genetic tasks, varied interest on genetic testing and preference for a shared care model with other genetic health professionals have resulted in minimal translation to clinical adoption. CONCLUSION This review highlights the need for deeper exploration of GPs' varied experience and attitudes towards clinical genetic services to better facilitate targeted intervention in the adoption of clinical genetics.
Collapse
Affiliation(s)
- Cheryl Siow Bin Ong
- Sociology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Rose Wai‑Yee Fok
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Ryo Chee Ann Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Si Ming Fung
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Shirley Sun
- Sociology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Joanne Yuen Yie Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| |
Collapse
|
2
|
Lopez Santibanez Jacome L, Dellefave-Castillo LM, Wicklund CA, Scherr CL, Duquette D, Webster G, Smith ME, Kalke K, Gordon AS, De Berg K, McNally EM, Rasmussen-Torvik LJ. Practitioners' Confidence and Desires for Education in Cardiovascular and Sudden Cardiac Death Genetics. J Am Heart Assoc 2022; 11:e023763. [PMID: 35322684 PMCID: PMC9075463 DOI: 10.1161/jaha.121.023763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Educating cardiologists and health care professionals about cardiovascular genetics and genetic testing is essential to improving diagnosis and management of patients with inherited cardiomyopathies and arrhythmias and those at higher risk for sudden cardiac death. The aim of this study was to understand cardiology and electrophysiology practitioners’ current practices, confidence, and knowledge surrounding genetic testing in cardiology and desired topics for an educational program. Methods and Results A one‐time survey was administered through purposive email solicitation to 131 cardiology practitioners in the United States. Of these, 107 self‐identified as nongenetic practitioners. Over three quarters of nongenetic practitioners reported that they refer patients to genetic providers to discuss cardiovascular genetic tests (n=82; 76.6%). More than half of nongenetic practitioners reported that they were not confident about the types of cardiovascular genetic testing available (n=60; 56%) and/or in ordering appropriate cardiovascular genetic tests (n=66; 62%). In addition, 45% (n=22) of nongenetic practitioners did not feel confident making cardiology treatment recommendations based on genetic test results. Among all providers, the most desired topics for an educational program were risk assessment (94%) and management of inherited cardiac conditions based on guidelines (91%). Conclusions This study emphasizes the importance of access to genetics services in the cardiology field and the need for addressing the identified deficit in confidence and knowledge about cardiogenetics and genetic testing among nongenetic providers. Additional research is needed, including more practitioners from underserved areas.
Collapse
Affiliation(s)
| | | | - Catherine A Wicklund
- Center for Genetic Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Courtney L Scherr
- Department of Communication Studies Northwestern University Chicago IL
| | - Debra Duquette
- Center for Genetic Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Gregory Webster
- Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL
| | - Maureen E Smith
- Center for Genetic Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Kerstin Kalke
- Department of Communication Studies Northwestern University Chicago IL
| | - Adam S Gordon
- Center for Genetic Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | | | - Elizabeth M McNally
- Center for Genetic Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Laura J Rasmussen-Torvik
- Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| |
Collapse
|
3
|
Jackson L, O'Connor A, Paneque M, Curtisova V, Lunt PW, Pourova RK, Macek M, Stefansdottir V, Turchetti D, Campos M, Henneman L, Godino L, Skirton H, Cornel MC. The Gen-Equip Project: evaluation and impact of genetics e-learning resources for primary care in six European languages. Genet Med 2018; 21:718-726. [PMID: 30050101 PMCID: PMC6752302 DOI: 10.1038/s41436-018-0132-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/29/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose Genetic advances mean patients at risk of genetic conditions can be helped through testing, clinical screening, and preventive treatment, but they must first be identified to benefit. Ensuring quality of genetic care for patients requires genetic expertise in all health services, including primary care. To address an educational shortfall, a series of e-learning resources was developed in six languages to equip primary care professionals with genetic skills relevant for practice. The purpose of the study was to evaluate these resources using Kirkpatrick’s framework for educational outcomes. Methods Mixed methods (qualitative and quantitative) were used over four phases of the study. Results A high level of satisfaction with the resources was reported. Knowledge and skills improved significantly after using the education material. Participants reported changes in confidence and practice behavior, including family history taking, seeking advice from specialists and referring patients. The resources helped users to learn how to explain genetics. Many visited the resources repeatedly and some used them to educate colleagues or students. Conclusion Gen-Equip modules are effective in improving genetic knowledge, skills, and attitudes for primary care professionals. They provide both continuing professional development and just-in-time learning for a potentially large global audience at a practical level.
Collapse
Affiliation(s)
- Leigh Jackson
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK.,University of Exeter Medical School, RILD building, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Anita O'Connor
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - Milena Paneque
- i3S Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC)-Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Vaclava Curtisova
- Dept. of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Palacky University-University Hospital Olomouc, Olomouc, Czech Republic
| | - Peter W Lunt
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - Radka Kremlíková Pourova
- Dept. of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Milan Macek
- Dept. of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | | | - Daniela Turchetti
- Department of Medical and Surgical Sciences, Unit of Medical Genetics, University of Bologna, Bologna, Italy
| | | | - Lidewij Henneman
- Department of Clinical Genetics, Section Community Genetics and Amsterdam Public Health research institute, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Lea Godino
- UO Oncologia, Policlinico Sant'Orsola Malpighi, Bologna, Italy
| | - Heather Skirton
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - Martina C Cornel
- Department of Clinical Genetics, Section Community Genetics and Amsterdam Public Health research institute, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
| |
Collapse
|