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遗传咨询对专科癌症诊所患者参与度的影响。

The impact of genetic counseling on patient engagement in a specialty cancer clinic.

作者信息

Zakas Anna L, Leifeste Claire, Dudley Beth, Karloski Eve, Afonso Samantha, Grubs Robin E, Shaffer John R, Durst Andrea L, Parkinson Michael D, Brand Randall

机构信息

Department of Human Genetics, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, Pennsylvania.

The University of Wisconsin Hospital and Clinics, Madison, Wisconsin.

出版信息

J Genet Couns. 2019 Oct;28(5):974-981. doi: 10.1002/jgc4.1149. Epub 2019 Jul 11.

Abstract

The identification of patient outcomes unique to the field of genetic counseling has become a recent priority of the profession. Current health-care efforts have targeted patient engagement as an outcome capable of improving population health and reducing health-care costs. This study analyzed patient engagement levels among 182 participants who underwent genetic counseling for gastrointestinal (GI) cancer risk assessment in an outpatient specialty clinic. Patients seen at the UPMC Hereditary GI Tumor Program completed a validated patient engagement measure, the Altarum Consumer Engagement (ACE), prior to undergoing genetic counseling and again three months after enrollment. Paired t test analysis was conducted to assess the changes in Total ACE scores, and within the following three domains: Navigation, Informed Choice, and Commitment. In the sample of 182 participants, Total ACE scores increased after genetic counseling (by 5.7%; p < .0001), as did all three domains (Commitment p = .0008; Navigation p = .0008; and Informed Choice p = .0016). This study is the first known report of patient engagement levels in individuals undergoing genetic counseling in a specialty cancer clinic and suggests that genetic counseling improves patient engagement levels.

摘要

识别遗传咨询领域特有的患者治疗效果已成为该行业近期的一项优先任务。当前的医疗保健工作将患者参与度作为一种能够改善人群健康状况并降低医疗成本的治疗效果。本研究分析了182名在门诊专科诊所接受胃肠道(GI)癌症风险评估遗传咨询的参与者的患者参与度水平。在UPMC遗传性胃肠道肿瘤项目就诊的患者在接受遗传咨询之前以及入组三个月后,完成了一项经过验证的患者参与度测量工具,即阿尔塔鲁姆消费者参与度(ACE)。进行配对t检验分析以评估ACE总分以及以下三个领域内的变化:导航、知情选择和承诺。在182名参与者的样本中,遗传咨询后ACE总分增加了(5.7%;p <.0001),所有三个领域的得分也都增加了(承诺p =.0008;导航p =.0008;知情选择p =.0016)。本研究是关于专科癌症诊所中接受遗传咨询的个体的患者参与度水平的已知首份报告,表明遗传咨询可提高患者参与度水平。

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