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Gholamzadeh M, Abtahi H, Ghazisaeeidi M. Applied techniques for putting pre-visit planning in clinical practice to empower patient-centered care in the pandemic era: a systematic review and framework suggestion. BMC Health Serv Res 2021; 21:458. [PMID: 33985502 PMCID: PMC8116646 DOI: 10.1186/s12913-021-06456-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022] Open
Abstract
Background One of the main elements of patient-centered care is an enhancement of patient preparedness. Thus, pre-visit planning assessment tools was emerged to prepare and involve patients in their treatment process. Objective The main objective of this article was to review the applied tools and techniques for consideration of putting pre-visit planning into practice. Methods Web of Science, Scopus, IEEE, and PubMed databases were searched using keywords from January 2001 to November 2020. The review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Then, qualitative analysis was done to suggest an appropriate framework by mapping the main concepts. Results Out of 385 citations were retrieved in initial database searches, 49 studies from ten countries were included. Applied pre-visit techniques can be classified into eight categories. Our results showed that almost 81% of studies were related to procedures that were done between each visit, while 42% of articles were related to before visits. Accordingly, the main approach of included articles was patient preparedness. While 38 studies reported this approach is effective, three studies reported the effectiveness of such tools as moderate, only two articles believed it had a low effect on improving patient-centered care. Conclusion This survey summarized the characteristics of published studies on pre-visit planning in the proposed framework. This approach could enhance the quality of patient care alongside enhancement patient-provider communication. However, such an approach can also be helpful to control pandemic diseases by reducing unnecessary referrals. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06456-7.
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Affiliation(s)
- Marsa Gholamzadeh
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, 5th Floor, Fardanesh Alley, Qods Ave, Tehran, Iran
| | - Hamidreza Abtahi
- Pulmonary and Critical care Medicine Department, Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghazisaeeidi
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, 5th Floor, Fardanesh Alley, Qods Ave, Tehran, Iran.
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Greenberg DC, Kamara D, Tatsugawa Z, Mendoza M, Pineda E, Holschneider CH, Zakhour M. The role of the genetic testing industry in patient education of hereditary cancer: An observational study assessing the quality of patient education videos. Gynecol Oncol 2021; 161:516-520. [PMID: 33618842 DOI: 10.1016/j.ygyno.2021.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Genetic testing (GT) companies have developed patient education videos to supplement or replace pre-test genetic counseling (GC) by certified genetic counselors (CGC). The aim of this study was to assess the quality of these videos compared to the standard of care (SOC). METHODS Videos from four major GT companies were selected from an internet search identifying pre-test patient education videos. A scoring rubric with 22 questions and 36 total points was devised to assess quality metrics, as described by the National Cancer Institute and National Society of Genetic Counselors. Twenty-two individuals with varying genetics expertise (3 gynecologic oncologists, 3 academic generalists, 4 CGC, a genetics community health worker, 3 cancer care navigators, and 8 medical students) scored each video. Scorers were blinded to others' assessments. RESULTS Invitae had the highest median score (26/36), followed by Myriad (22/36), Ambry (17.5/36), and Color (15/36). All videos scored highly in explaining DNA basics, cancer development, and hereditary cancer predisposition. All addressed benefits of GT but failed to address potential disadvantages. All scored poorly in explaining medical terms and different GT options. There was variability in addressing patient concerns including cost, privacy, and procedure. CONCLUSIONS There is significant variation in the content of pre-test patient education videos between GT companies. None of the videos met the SOC for pre-test GC, and none addressed disadvantages of GT, possibly due to a conflict of interest. With improvement in content, accessibility, and use of interactive platforms, these videos may serve as an adjunct to in-person pre-test GC.
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Affiliation(s)
- D C Greenberg
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UC Irvine Department of Obstetrics and Gynecology, Orange, CA, USA
| | - D Kamara
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA
| | - Z Tatsugawa
- Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - M Mendoza
- Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - E Pineda
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - C H Holschneider
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - M Zakhour
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA.
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Lipson‐Smith R, Hyatt A, Murray A, Butow P, Hack TF, Jefford M, Ozolins U, Hale S, Schofield P. Measuring recall of medical information in non-English-speaking people with cancer: A methodology. Health Expect 2018; 21:288-299. [PMID: 28940931 PMCID: PMC5750741 DOI: 10.1111/hex.12614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients' memory of medical information. OBJECTIVES This study aimed to develop a method for eliciting and coding recall of medical information in non-English-speaking patients. DESIGN This method, called Patient-Interpreter-Clinician coding (PICcode), was developed in the context of a phase II trial conducted in two outpatient oncology clinics in Melbourne, Australia, and was refined iteratively through consultation with an expert panel and piloting. Between-coder differences in early versions of the coding system were resolved through discussion and consensus resulting in refinements to PICcode. RESULTS The final version of PICcode involved transcribing, translating and coding of audio-recorded consultations and semi-structured interviews (SSI). The SSIs were designed to elicit patients' free-recall of medical information. Every unit of medical information in the consultation was identified and categorized in a coding tree. SSIs were coded to identify the extent to which information was recalled from the consultation. DISCUSSION The iterative changes involved in developing PICcode assisted in clarifying precise details of the process and produced a widely applicable coding system. PICcode is the most comprehensively described method of determining the amount of information that patients who use an interpreter recall from their medical consultations. PICcode can be adapted for English-speaking patients and other healthcare populations.
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Affiliation(s)
- Ruby Lipson‐Smith
- Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneVICAustralia
| | - Amelia Hyatt
- Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneVICAustralia
| | - Alexandra Murray
- Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneVICAustralia
| | - Phyllis Butow
- School of PsychologyUniversity of SydneySydneyNSWAustralia
- Centre of Medical Psychology and Evidence‐Based Decision‐MakingUniversity of SydneySydneyNSWAustralia
- Psycho‐Oncology Cooperative Research GroupUniversity of SydneySydneyNSWAustralia
| | - Thomas F. Hack
- College of NursingUniversity of ManitobaWinnipegMBCanada
- CancerCare Manitoba Research InstituteWinnipegMBCanada
- School of Health Sciences, University of Central Lancashire PrestonUK
| | - Michael Jefford
- Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneVICAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVICAustralia
| | - Uldis Ozolins
- School of Humanities and LanguagesUniversity of New South WalesSydneyNSWAustralia
| | - Sandra Hale
- School of Humanities and LanguagesUniversity of New South WalesSydneyNSWAustralia
| | - Penelope Schofield
- Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneVICAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneVICAustralia
- Department of Psychological SciencesSwinburne University of TechnologyMelbourneVICAustralia
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Mills R, Ensinger M, Callanan N, Haga SB. Development and Initial Assessment of a Patient Education Video about Pharmacogenetics. J Pers Med 2017; 7:jpm7020004. [PMID: 28587070 PMCID: PMC5491980 DOI: 10.3390/jpm7020004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/19/2017] [Accepted: 05/18/2017] [Indexed: 11/16/2022] Open
Abstract
As few patient-friendly resources about pharmacogenetics are currently available, we aimed to create and assess a patient educational video on pharmacogenetic testing. A primary literature and resources review was conducted to inform the content and the format of the video. The educational video was then created using a commercially available animation program and pilot tested in focus groups of the general public and by an online survey of pharmacists. Emerging themes from the focus groups and survey indicate a desire for appropriate risk contextualization and specific examples when pharmacogenetic testing may be beneficial. Focus group participants also expressed a preference for a video with live action, and more text to reinforce concepts. Pharmacists generally felt that the video was understandable for patients and relevant for decision-making regarding testing. Using this initial feedback and the identification of important concepts to include in pharmacogenetics educational tools, we plan to revise the video, perform additional evaluations, and publish the video for public use in the future.
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Affiliation(s)
- Rachel Mills
- Duke University Department of Medicine, Center for Applied Genomics and Precision Medicine, 304 Research Drive, Box 90141, Durham, NC 27710, USA.
| | - Megan Ensinger
- OhioHealth Genetic Counseling Program, Bing Cancer Center, 500 Thomas Ln Ste 2D Columbus, Columbus, OH 43214, USA.
| | - Nancy Callanan
- University of North Carolina, Greensboro School of Health and Human Services, Genetic Counseling Program, 1400 Spring Garden St. Greensboro, Greensboro, NC 27412, USA.
| | - Susanne B Haga
- Duke University Department of Medicine, Center for Applied Genomics and Precision Medicine, 304 Research Drive, Box 90141, Durham, NC 27710, USA.
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Haga SB, Mills R, Moaddeb J. Evaluation of a pharmacogenetic educational toolkit for community pharmacists. Pharmacogenomics 2016; 17:1491-502. [PMID: 27533631 DOI: 10.2217/pgs-2016-0002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Over the past several decades, the roles and services of community pharmacists have expanded beyond traditional medical dispensation and compounding, and include health services such as vaccinations, and clinical testing and screening. Incorporating pharmacogenetic (PGx) testing into the menu of pharmacy services is logical and feasible; however, few pharmacists have experience with PGx testing, and few educational resources about PGx are available to support the uptake of PGx testing in community pharmacies. METHODS We developed a toolkit of four resources to assist pharmacists to provide PGx testing. We conducted a survey of pharmacists in North Carolina to evaluate each component of the toolkit and the toolkit as a whole. RESULTS A total of 380 respondents completed the evaluation of one or more toolkit components (344 evaluated all four components and the overall toolkit). Most respondents (84%) have never ordered or used PGx test results. Though the usability of the toolkit overall was below average (65.1 on a range of 0-100), individual components were perceived as useful and more than 75% of pharmacists reported that they would use the toolkit components when offering testing, with the result summary sheet receiving the highest score (4.01 out of 5). Open-text comments highlighted the need for more patient-friendly language and formatting. CONCLUSION The majority of pharmacist respondents scored the components of the toolkit favorably. The next steps will be to revise and assess use of the toolkit in community pharmacy settings.
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Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics & Precision Medicine, Duke University, School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
| | - Rachel Mills
- Center for Applied Genomics & Precision Medicine, Duke University, School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
| | - Jivan Moaddeb
- Center for Applied Genomics & Precision Medicine, Duke University, School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
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van Bruinessen IR, van der Hout LE, van Weel-Baumgarten EM, Gouw H, Zijlstra JM, van Dulmen S. Communication during haematological consultations; patients' preferences and professionals' performances. Ann Hematol 2016; 95:1177-83. [PMID: 27091348 DOI: 10.1007/s00277-016-2669-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/07/2016] [Indexed: 11/30/2022]
Abstract
Many patients with haematological malignancies experience barriers in clinical communication. Reaching effective communication is of great importance as it has been linked to a range of improved patient outcomes such as satisfaction, compliance to treatment, perceived quality of life and physical and mental health. To get a better understanding how communication in haematological consultations can be improved, the current study focussed on patients' preferences and perceived performances regarding the communicative behaviour of their health care professional. Secondly, the mediation of an online communication tool for patients was analysed. Within a controlled pre- post-test design, 78 datasets of clinical consultations could be analysed. Patients considered both affective and instrumental communication aspects important. The affective communication behaviour of the health care professional met the patients' pre-visit preferences well. In the information exchange, more variability and discrepancies were found. Overall, the online intervention did not seem to influence the patients' perceived communication performance of their health care professional much. To further improve the communication during clinical consultations, health care professionals should inquire about patients' expectations, especially during the exchange of information and advices. At the same time, patients should be supported to express their preferences at the start of the consultation. The study was registered in the Netherlands Trial Register, number 3779.
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Affiliation(s)
- Inge R van Bruinessen
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
| | - Lotte E van der Hout
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - Hans Gouw
- Hematon (Dutch Patient Association for Leukaemia, Malignant Lymphoma and Stem Cell Transplantation), Amersfoort, The Netherlands
| | - Josée M Zijlstra
- Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Sandra van Dulmen
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.,Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway
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7
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Miller N, Rogers SN. A review of question prompt lists used in the oncology setting with comparison to the Patient Concerns Inventory. Eur J Cancer Care (Engl) 2016; 27. [PMID: 26989045 DOI: 10.1111/ecc.12489] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2016] [Indexed: 12/01/2022]
Abstract
A question prompt list (QPL) is a simple and inexpensive communication tool used to facilitate patient participation in medical consultations. The QPL is composed of a structured list of questions and has been shown to be an effective way of helping ensure patients' individual information needs are appropriately met. This intervention has been investigated in a variety of settings but not specifically head and neck cancer (HNC). The aim of this paper was to perform a narrative review of literature reporting the use of a QPL for oncology patients and to draw comparison to the Patient Concerns Inventory (PCI-HN). The databases Scopus, PubMed and MEDLINE were searched using the key terms 'question prompt list', 'question prompt sheet', 'cancer' and 'oncology'. Of 98 articles hand searched, 30 of which were found to meet all inclusion criteria, and described in a tabulated summary. The studies concluded that the QPL was an effective intervention, enabling active patient participation in medical consultations. The PCI-HN is specific for HNC and differs from many QPLs, which are more general cancer tools. The QPL approach should prove to be a useful intervention for HNC sufferers, however further research into the clinical utility is required.
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Affiliation(s)
- N Miller
- Liverpool University, Liverpool, UK
| | - S N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK.,University Hospital Aintree, Liverpool, UK
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8
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de Geus E, Aalfs CM, Menko FH, Sijmons RH, Verdam MGE, de Haes HCJM, Smets EMA. Development of the Informing Relatives Inventory (IRI): Assessing Index Patients' Knowledge, Motivation and Self-Efficacy Regarding the Disclosure of Hereditary Cancer Risk Information to Relatives. Int J Behav Med 2016; 22:551-60. [PMID: 25515913 DOI: 10.1007/s12529-014-9455-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the use of genetic services, counselees do not always share hereditary cancer information with at-risk relatives. Reasons for not informing relatives may be categorized as a lack of: knowledge, motivation, and/or self-efficacy. PURPOSE This study aims to develop and test the psychometric properties of the Informing Relatives Inventory, a battery of instruments that intend to measure counselees' knowledge, motivation, and self-efficacy regarding the disclosure of hereditary cancer risk information to at-risk relatives. METHOD Guided by the proposed conceptual framework, existing instruments were selected and new instruments were developed. We tested the instruments' acceptability, dimensionality, reliability, and criterion-related validity in consecutive index patients visiting the Clinical Genetics department with questions regarding hereditary breast and/or ovarian cancer or colon cancer. RESULTS Data of 211 index patients were included (response rate = 62%). The Informing Relatives Inventory (IRI) assesses three barriers in disclosure representing seven domains. Instruments assessing index patients' (positive) motivation and self-efficacy were acceptable and reliable and suggested good criterion-related validity. Psychometric properties of instruments assessing index patients knowledge were disputable. These items were moderately accepted by index patients and the criterion-related validity was weaker. CONCLUSION This study presents a first conceptual framework and associated inventory (IRI) that improves insight into index patients' barriers regarding the disclosure of genetic cancer information to at-risk relatives. Instruments assessing (positive) motivation and self-efficacy proved to be reliable measurements. Measuring index patients knowledge appeared to be more challenging. Further research is necessary to ensure IRI's dimensionality and sensitivity to change.
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Affiliation(s)
- Eveline de Geus
- Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands,
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Chang Y, Near AM, Butler KM, Hoeffken A, Edwards SL, Stroup AM, Kohlmann W, Gammon A, Buys SS, Schwartz MD, Peshkin BN, Kinney AY, Mandelblatt JS, Chang Y, Near AM, Butler KM, Hoeffken A, Edwards SL, Stroup AM, Kohlmann W, Gammon A, Buys SS, Schwartz MD, Peshkin BN, Kinney AY, Mandelblatt JS. Economic Evaluation Alongside a Clinical Trial of Telephone Versus In-Person Genetic Counseling for BRCA1/2 Mutations in Geographically Underserved Areas. J Oncol Pract 2016; 12:59, e1-13. [PMID: 26759468 PMCID: PMC4960460 DOI: 10.1200/jop.2015.004838] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE BRCA1/2 counseling and mutation testing is recommended for high-risk women, but geographic barriers exist, and no data on the costs and yields of diverse delivery approaches are available. METHODS We performed an economic evaluation with a randomized clinical trial comparing telephone versus in-person counseling at 14 locations (nine geographically remote). Costs included fixed overhead, variable staff, and patient time costs; research costs were excluded. Outcomes included average per-person costs for pretest counseling; mutations detected; and overall counseling, testing, and disclosure. Sensitivity analyses were performed to assess the impact of uncertainty. RESULTS In-person counseling was more costly per person counseled than was telephone counseling ($270 [range, $180 to $400] v $120 [range, $80 to $200], respectively). Counselors averaged 285 miles round-trip to deliver in-person counseling to the participants (three participants per session). There were no differences by arm in mutation detection rates (approximately 10%); therefore, telephone counseling was less costly per positive mutation detected than was in-person counseling ($37,160 [range, $36,080 to$38,920] v $40,330 [range, $38,010 to $43,870]). In-person counseling would only be less costly than telephone counseling if the most favorable assumptions were applied to in personc ounseling and the least favorable assumptions were applied to telephone counseling. CONCLUSION In geographically underserved areas, telephone counseling is less costly than in-person counseling.
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Affiliation(s)
- Yaojen Chang
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Aimee M. Near
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Karin M. Butler
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Amanda Hoeffken
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Sandra L. Edwards
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Antoinette M. Stroup
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Wendy Kohlmann
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Amanda Gammon
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Saundra S. Buys
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Marc D. Schwartz
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Beth N. Peshkin
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Anita Y. Kinney
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Jeanne S. Mandelblatt
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT,Corresponding author: Jeanne S. Mandelblatt, MD, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St NW, Suite 4100, Washington, DC 20007; e-mail:
| | - Yaojen Chang
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Aimee M Near
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Karin M Butler
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Amanda Hoeffken
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Sandra L Edwards
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Antoinette M Stroup
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Wendy Kohlmann
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Amanda Gammon
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Saundra S Buys
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Marc D Schwartz
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Beth N Peshkin
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Anita Y Kinney
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Jeanne S Mandelblatt
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; University of New Mexico Cancer Center, Albuquerque, NM; and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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Thompson S, Noblin SJ, Lemons J, Peterson SK, Carreno C, Harbison A. Perceptions of Latinas on the Traditional Prenatal Genetic Counseling Model. J Genet Couns 2015; 24:675-82. [PMID: 25475921 DOI: 10.1007/s10897-014-9797-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 11/17/2014] [Indexed: 02/03/2023]
Abstract
The traditional genetic counseling model encompasses an individualized counseling session that includes the presentation of information about genes, chromosomes, personalized risk assessment, and genetic testing and screening options. Counselors are challenged to balance the provision of enough basic genetic information to ensure clients' understanding of the genetic condition in question with a personalized discussion of what this information means to them. This study explored the perceptions Latinas have about prenatal genetic counseling sessions and aimed to determine if they had preferences about the delivery of care. Data were collected through focus groups and one-on-one, semi-structured interviews of 25 Spanish speaking Latinas who received genetic counseling during their current pregnancy. We implemented grounded theory to evaluate participant responses, and were able to identify common emergent themes. Several themes were identified including an overall satisfaction with their prenatal genetic counseling appointment, desire for a healthy baby, peace of mind following their appointment, lack of desire for invasive testing, and faith in God. Several participants stated a preference for group genetic counseling over the traditional individual genetic counseling model. Our data indicate that Latinas value the information presented at prenatal genetic counseling appointments despite disinterest in pursuing genetic testing or screening and suggest that group prenatal genetic counseling may be an effective alternative to the traditional genetic counseling model in the Latina population.
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Affiliation(s)
- Stephanie Thompson
- Genetic Counseling Program, The University of Texas Graduate School of Biomedical Science at Houston, Houston, TX, 77030, USA,
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11
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Haga SB, Allen LaPointe NM, Moaddeb J. Challenges to integrating pharmacogenetic testing into medication therapy management. J Manag Care Spec Pharm 2015; 21:346-52. [PMID: 25803768 PMCID: PMC4522310 DOI: 10.18553/jmcp.2015.21.4.346] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Some have proposed the integration of pharmacogenetic (PGx) testing into medication therapy management (MTM) to enable further refinement of treatments to reduce risk of adverse responses and improve efficacy. PGx testing involves the analysis of genetic variants associated with therapeutic or adverse response and may be useful in enhancing the ability to identify ineffective and/or harmful drugs or drug combinations. This "enhanced" MTM might also reduce patient concerns about side effects and increase confidence that the medication is effective, addressing 2 key factors that impact patient adherence: concern and necessity. However, the feasibility and effectiveness of the integration of PGx testing into MTM in clinical practice has not yet been determined. In this commentary, we consider some of the challenges to the integration and delivery of PGx testing in MTM services.
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Affiliation(s)
- Susanne B Haga
- Duke University School of Medicine, 304 Research Dr., Box 90141, Durham, NC 27708.
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Health care in systemic lupus erythematosus (SLE): the patient’s perspective. Clin Rheumatol 2014; 33:1279-87. [DOI: 10.1007/s10067-014-2595-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 01/08/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
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Dieng M, Watts CG, Kasparian NA, Morton RL, Mann GJ, Cust AE. Improving subjective perception of personal cancer risk: systematic review and meta-analysis of educational interventions for people with cancer or at high risk of cancer. Psychooncology 2014; 23:613-25. [PMID: 24420128 DOI: 10.1002/pon.3476] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 12/10/2013] [Accepted: 12/10/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Newly diagnosed patients with cancer require education about the disease, the available treatments and potential consequences of treatment. Greater understanding of cancer risk has been found to be associated with greater health-related quality of life, improved psychological adjustment and greater health-related behaviours. The aim of this sytematic review was to assess the effectiveness of educational interventions in improving subjective cancer risk perception and to appraise the quality of the studies. METHODS We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies. Eligible studies were identified via Medline, PsycINFO, AMED, CINAHL and Embase databases. After screening titles and abstracts, two reviewers independently assessed the eligibility of 206 full-text articles. RESULTS Forty papers were included in the review; the majority of studies were conducted among breast cancer patients (n = 29) and evaluated the effect of genetic counselling on personal perceived risk (n = 25). Pooled results from RCTs (n = 12) showed that, both in the short and long term, educational interventions did not significantly influence risk perception level (standardised mean difference 0.05, 95% CI -0.24-0.34; p = 0.74) or accuracy (odds ratio = 1.96, 95% CI: 0.61-6.25; p = 0.26). Only one RCT reported a short-term difference in risk ratings (p = 0.01). Of prospective observational studies (n = 28), many did demonstrate changes in the level of perceived risk and improved risk accuracy and risk ratings in both the short and long term. However, only one (of three) observational studies reported a short-term difference in risk ratings (p < = 0.003). CONCLUSION Further development and investigation of educational interventions using good quality, RCTs are warranted.
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Affiliation(s)
- Mbathio Dieng
- Cancer Epidemiology and Services Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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Maio M, Carrion P, Yaremco E, Austin JC. Awareness of genetic counseling and perceptions of its purpose: a survey of the Canadian public. J Genet Couns 2013; 22:762-70. [PMID: 23963834 DOI: 10.1007/s10897-013-9633-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
Abstract
Genetic counseling can result in better outcomes when clients understand what to expect, and at least theoretically, at some point in their lifespan, anyone could be referred for or benefit from genetic counseling. Thus, in order to identify (and ultimately address) issues around awareness of genetic counseling and perceptions of its purpose, we surveyed the Canadian general population. We acquired 1,000 telephone numbers corresponding to a demographically representative sample of Canada from Survey Sampling International, and invited individuals to participate in a telephone-based survey. We administered a purpose-designed survey (in either French or English) comprising questions regarding: demographics, whether or not the individual had heard of genetic counseling, and 15 Likert scale-rated (strongly disagree-strongly agree) items about the possible purposes of genetic counseling. Responses to these 15 items were used to generate a total "knowledge score". Of the 1,000 numbers, n = 372 could not be reached, and the survey was successfully administered to n = 188 individuals (response rate 30 %). Most respondents (n = 129, 69 %) had not heard of genetic counseling, and substantial proportions thought that genetic counseling aims to prevent genetic diseases and abnormalities, help couples have children with desirable characteristics, and help people to understand their ancestry. These data could be used to inform the strategy for development of future awareness efforts, and as a baseline from which to measure their effects.
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Affiliation(s)
- Melissa Maio
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
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Albada A, van Dulmen S, Bensing JM, Ausems MGEM. Retraction: Effects of a pre-visit educational website on information recall and needs fulfilment in breast cancer genetic counselling, a randomized controlled trial. Breast Cancer Res 2012; 14:402. [PMID: 23130551 PMCID: PMC4053114 DOI: 10.1186/bcr3339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Linn AJ, van Weert JCM, Schouten BC, Smit EG, van Bodegraven AA, van Dijk L. Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior. Patient Prefer Adherence 2012; 6:871-85. [PMID: 23271896 PMCID: PMC3526884 DOI: 10.2147/ppa.s36195] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The barriers to patients' successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior. PATIENTS AND METHODS Based on a literature review, the practical and perceptual barriers to successful medication intake behavior typology (PPB-typology) was developed. The PPB-typology addresses four potential types of barriers that can be either practical (memory and daily routine barriers) or perceptual (concern and necessity barriers). The typology describes tailored communication strategies that are organized according to barriers and communication strategies that are organized according to provider and patient roles. Eighty consultations concerning first-time medication use between nurses and inflammatory bowel disease patients were videotaped. The verbal content of the consultations was analyzed using a coding system based on the PPB-typology. The Medication Understanding and Use Self-efficacy Scale and the Beliefs about Medicine Questionnaire Scale were used as indicators of patients' barriers and correlated with PPB-related scores. RESULTS The results showed that nurses generally did not communicate with patients according to the typology. However, when they did, fewer barriers to successful medication intake behavior were identified. A significant association was found between nurses who encouraged question-asking behavior and memory barriers (r = -0.228, P = 0.042) and between nurses who summarized information (r = -0.254, P = 0.023) or used cartoons or pictures (r = -0.249, P = 0.026) and concern barriers. Moreover, a significant relationship between patients' emotional cues about side effects and perceived concern barriers (r = 0.244, P = 0.029) was found as well. CONCLUSION The PPB-typology provides communication recommendations that are designed to meet patients' needs and assist providers in the promotion of successful medication intake behavior, and it can be a useful tool for developing effective communication skills training programs.
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Affiliation(s)
- Annemiek J Linn
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
- Correspondence: Annemiek J Linn, Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands, Tel +31 20 525 3974, Fax +31 20 525 3681, Email
| | - Julia CM van Weert
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Barbara C Schouten
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Edith G Smit
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | | | - Liset van Dijk
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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