Highlights
- •Improvement needed in efforts for universal testing in gynecology oncology.
- •Implementation of simple measures can have large impact on achieving this goal.
- •Education of providers is an effective way of impacting universal testing rates.
- •Patients who see genetic counselors have a high rate of testing completion.
Abstract
Objective
The National Comprehensive Cancer Network recommends all women with ovarian cancer
be offered genetic testing. Despite a decade of endorsement, many oncology practitioners
have yet to make this a part of routine practice. Referral to genetic counseling and
completion of genetic testing among patients at substantial risk of germline mutations
are significantly lacking, adversely affecting patient care and squandering an opportunity
to maximize cancer prevention efforts. This project determined the impact and feasibility
of implementing a basic model for universal referral to genetic counseling and completion
of genetic testing in women with a diagnosis of ovarian cancer in an academic gynecology
oncology practice with access to electronic health records (EHRs).
Methods
Patients diagnosed with ovarian cancer from January 2008 to November 2013 were retrospectively
reviewed to determine the baseline referral rate for genetic counseling and testing
completion in our practice. Implementation of a process change model combining provider training, patient education, enhanced electronic health record documentation and improved patient appointment scheduling strategies were implemented. We then prospectively collected data on all newly diagnosed
ovarian cancer patients that had not already undergone genetic testing presenting
from December 1, 2013 to November 30, 2016.
Results
Genetic referral rates, genetic counseling and testing completion rates were markedly
improved. Pre-implementation our genetic testing rate was 27% and post implementation
our testing rate was 82% (p-value ≤ 0.001).
Conclusions
Low cost interventions that target education of both providers and patients regarding
the importance of genetic testing along with utilization of the EHR and streamlined
patient appointment services can significantly increase rates of genetic testing completion.
Keywords
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Article info
Publication history
Published online: April 10, 2018
Accepted:
March 25,
2018
Received in revised form:
March 21,
2018
Received:
December 14,
2017
Footnotes
☆No conflicts of interest or financial disclosures.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
