Top

Published in:

01-10-2012 | Original Research

The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

Authors: Carol A. Christianson, Karen Potter Powell, Susan Estabrooks Hahn, Susan H. Blanton, Jessica Bogacik, Vincent C. Henrich, The Genomedical Connection

Published in: Journal of Genetic Counseling | Issue 5/2012

Abstract

Primary care providers (PCPs) offered input regarding the incorporation of a family health history (FHH) risk assessment tool into a community health care system (CHCS). Sixteen PCPs participated in one of three focus groups. Perceived impediments included the lack of standard screening guidelines, effective screening tests, genetic counseling resources, and services for high-risk patients. The PCPs were concerned about their level of expertise, the cost of preventive health care, and genetic discrimination. They also were concerned about the use of a FHH tool by oncologists within the CHCS because of communication gaps between oncologists and PCPs, lack of clarity regarding follow-up and legal liability, and reimbursement issues. To integrate a FHH tool into a CHCS, PCPs will need consultation and referral services, evidence-based recommendations, and “just-in-time” educational resources. Oncologists who use the tool will need to develop a streamlined communication system with PCPs, establish clearly defined roles, and ensure patient follow-up.

Abrahams, E., Ginsburg, G. S., & Silver, M. (2005). The personalized medicine coalition: goals and strategies. American Journal of Pharmacogenomics, 5, 345–355.PubMedCrossRef

Bell, J. (1998). The new genetics: the new genetics in clinical practice. British Journal of Medicine, 316, 618–620.CrossRef

Blumenthal, D., Causino, N., Change, Y. C., Culpepper, L., Marder, W., Saglam, D., et al. (1999). The duration of ambulatory visits to physicians. Journal of Family Practice, 48, 264–271.PubMed

Burke, W., & Emery, J. (2002). Genetics education for primary-care providers. Nature Review Genetics, 3, 561–566.CrossRef

Burke, W., Acheson, L., Botkin, J., Bridges, K., Davis, A., Evans, J., et al. (2002). Genetics in primary care: a USA faculty development initiative. Community Genetics, 5, 138–46.PubMedCrossRef

Carroll, J. C., Rideout, A. L., Wilson, B. J., Allanson, J., Blaine, S. M., Esplen, M. J., et al. (2009). Genetic education for primary care providers: improving attitudes, knowledge, and confidence. Cancer Family Physician, 55, e92–99.

Christianson, C. A., Powell, K. P., Hahn, S. E., Bartz, D., Roxbury, T., Blanton, S. H., et al. (2010). Findings from a community education needs assessment to facilitate the integration of genomic medicine into primary care. Genetics in Medicine, 12(9), 587–593.PubMedCrossRef

Clyman, J. C., Nazir, F., Tarolli, S., Black, E., Lombardi, R. Q., & Higgins, J. J. (2007). The impact of a genetics education program on physicians’ knowledge and genetic counseling referral patterns. Medical Teacher, 29, e143–e150.PubMedCrossRef

Cohn, W. F., Ropka, M. E., Pelletier, S. L., Barrett, J. R., Kinzie, M. B., Harrison, M. B., et al. (2010). Health Heritage^©, a web-based tool for the collection and assessment of family history: initial user experience and analytic validity. Public Health Genomics, 13, 477–491.PubMedCrossRef

Collins, F. (1997). Preparing health professionals for the genetic revolution. Journal of the American Medical Association, 278, 1285–1286.PubMedCrossRef

Collins, F. S., & Guttmacher, A. E. (2001). Genetics moves into the medical mainstream. Journal of the American Medical Association, 286, 2322–2324.PubMedCrossRef

Core Competencies for all health care professionals. (2007). National Coalition for Health Professional Education in Genetics, available at: http://www.nchpeg.org/index.php?option=com_content&view=article&id=94&Itemid=84, accessed 23 October 2010.

de Bock, G. H., Vliet Vlieland, T. P. M., Hageman, G. C. H. A., Oosterwijk, J. C., Springer, M. P., & Kievit, J. (1999). The assessment of genetic risk of breast cancer: a set of GP guidelines. Family Practice, 16, 71–77.PubMedCrossRef

Emery, J. (1999). Computer support for genetic advice in primary care. British Journal of General Practice, 49, 572–575.PubMed

Friedman, L. C., Plon, S. E., Cooper, H. P., & Weinberg, A. D. (1997). Cancer genetics: survey of primary care physicians’ attitudes and practices. Journal of Cancer Education, 12, 199–203.PubMed

Fry, A., Campbell, H., Gudmundsdottir, H., Rush, R., Porteous, M., Gorman, D., & Cull, A. (1999). GPs’ views on their role in cancer genetics services and current practice. Family Practice, 16(5), 468–474.PubMedCrossRef

Ginsburg, G. S., & Willard, H. F. (2009). Genomic and personalized medicine: foundations and applications. Translational Research, 154, 277–287.PubMedCrossRef

Greendale, K., & Pyeritz, R. E. (2001). Empowering primary care health professionals in medical genetics: how soon? How fast? How far? American Journal of Medical Genetics, 106, 223–232.PubMedCrossRef

Guttmacher, A. E., & Collins, F. S. (2002). Genomic medicine—a primer. New England Journal of Medicine, 347, 1512–1520.PubMedCrossRef

Harvey, E. K., Fogel, C. E., Peyrot, M., Christensen, K. D., Terry, S. F., & McInerney, J. D. (2007). Providers’ knowledge of genetics: a survey of 5915 individuals and families with genetic conditions. Genetics in Medicine, 9, 259–267.PubMedCrossRef

Hayflick, S. J., Eiff, P., Carpenter, L., & Steinberger, J. (1998). Primary care physicians’ utilization and perception of genetics service. Genetics in Medicine, 1, 13–21.PubMedCrossRef

Julian-Reynier, C., Nippert, I., Calefato, J. M., Harris, H., Kristofferson, U., Schmidtke, J., et al. (2008). Genetics in clinical practice: general practitioners’ educational priorities in European countries. Genetics in Medicine, 10(2), 107–113.PubMedCrossRef

Kemper, A. R., Trotter, T. L., Lloyd-Puryear, M. A., Kyler, P., Feero, W. G., & Howell, R. R. (2010). A blueprint for maternal and child health primary care physician education in medical genetics and genomic medicine. Genetics in Medicine, 12(2), 77–80.PubMedCrossRef

Khoury, M. J., Burke, W., & Thomson, E. J. (2000). Genetics and public health in the 21st century: Using genetic information to improve health and prevent disease. New York: Oxford University Press.

Korf, B. R. (2002). Integration of genetics into clinical teaching in medical school education. Genetics in Medicine, 4, 33S–38S.PubMedCrossRef

Krueger, R. (1994). Focus groups: A practical guide for applied research (2nd ed.). California: SAGE Publications.

Laberge, A. M., Fryer-Edwards, K., Kyler, P., Lloyd-Puryear, M. A., & Burke, W. (2009). Long-term outcomes of the “Genetics in Primary Care” faculty development initiative. Family Medicine, 41(4), 266–70.PubMed

Lucassen, A., Watson, E., Harcourt, J., Rose, P., & O’Grady, J. (2001). Guidelines for referral to a regional genetics service: GPs respond by referring more appropriate cases. Family Practice, 18, 135–140.PubMedCrossRef

Metcalf, S., Hurworth, R., Newstead, J., & Robins, R. (2002). Needs assessment study of genetics education for general practitioners in Australia. Genetics in Medicine, 4(2), 71–77.CrossRef

My family health portrait: A tool from the Surgeon General. (2010). U.S. Department of Health and Human Services, available at https://familyhistory.hhs.gov/fhh-web/home.action, accessed 7 May 2010.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™). (2011). National Comprehensive Cancer Network, available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp, accessed 1 March 2011.

Qureshi, N., Wilson, B., Santaguida, P., Little, J., Carroll, J., Allanson, J., et al. (2009). NIH State-of-the-Science Conference: Family History and Improving Health. Evidence Report/Technology Assessment No. 186. (Prepared by the McMaster University Evidence-based Practice Center, under Contract No. 290-2007-10060-I.) AHRQ Publication No. 09-E016. Rockville, MD: Agency for Healthcare Research and Quality.

Rich, E. C., Burke, W., Heaton, C. J., Haga, S., Pinsky, L., Short, M. P., & Acheson, L. (2004). Reconsidering the family history in primary care. Journal of General Internal Medicine, 19, 273–280.PubMedCrossRef

Smith, A. N., & Scott, J. A. (1988). Innovations in human genetics education. Genetic applications for health professionals: an outreach continuing-education model program. American Journal of Human Genetics, 43, 559–562.PubMed

Suther, M. A., & Goodson, P. (2003). Barriers to the provision of genetic services by primary care physicians: a systematic review of the literature. Genetics in Medicine, 5(2), 70–76.PubMedCrossRef

Trinidad, S. B., Fryer-Edwards, K., Crest, A., Kyler, P., Lloyd-Puryear, M. A., & Burke, W. (2008). Educational needs in genetic medicine: primary care perspective. Community Genetics, 11, 160–165.PubMedCrossRef

Valdez, R., Yoon, P. W., Qureshi, N., Green, R. F., & Khoury, M. J. (2010). Family history in public health practice: a genomic tool for disease prevention and health promotion. Annual Review of Public Health, 31, 69–87.PubMedCrossRef

Watson, E. K., Shickle, D., Qureshi, N., Emery, J., & Austoker, J. (1999). The “new genetics” and primary care: GPs’ views on their role and their educational needs. Family Practice, 16, 420–425.PubMedCrossRef

Yoon, P. W., Scheuner, M. T., Jorgensen, C., & Khoury, M. J. (2009). Developing Family Healthware, a family history screening tool to prevent common chronic diseases. Preventing Chronic Disease, 6(1), 1–11.

Title: The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers
Authors: Carol A. Christianson
Karen Potter Powell
Susan Estabrooks Hahn
Susan H. Blanton
Jessica Bogacik
Vincent C. Henrich
The Genomedical Connection
Publication date: 01-10-2012
Publisher: Springer US
Published in: Journal of Genetic Counseling / Issue 5/2012
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI: https://doi.org/10.1007/s10897-011-9479-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2012

Hispanic Infants with Cystic Fibrosis Show Low CFTR Mutation Detection Rates in the Illinois Newborn Screening Program

Low Rates of African American Participation in Genetic Counseling and Testing for BRCA1/2 Mutations: Racial Disparities or Just a Difference?

Personal Genomic Testing as Part of the Complete Breast Cancer Risk Assessment: A Case Report

Prenatal Treatment of Congenital Adrenal Hyperplasia—Not Standard of Care

Couples’ Coping in Prodromal Huntington Disease: A Mixed Methods Study

Biotech 101: An Educational Outreach Program in Genetics and Biotechnology