Implementation and outcomes of telephone disclosure of clinical BRCA1/2 test results.
OBJECTIVE
With an increasing demand for genetic services, effective and efficient delivery models for genetic testing are needed.


METHODS
In this prospective single-arm communication study, participants received clinical BRCA1/2 results by telephone with a genetic counselor and completed surveys at baseline, after telephone disclosure (TD) and after in-person clinical follow-up.


RESULTS
Sixty percent of women agreed to participate; 73% of decliners preferred in-person communication. Anxiety decreased from baseline to post-TD (p=0.03) and satisfaction increased (p<0.01). Knowledge did not change significantly from baseline to post-TD, but was higher post-clinical follow-up (p=0.04). Cancer patients had greater declines in state anxiety and African-American participants reported less increase in satisfaction. 28% of participants did not return for in-person clinical follow-up, particularly those with less formal education, and higher post-disclosure anxiety and depression (p<0.01).


CONCLUSIONS
Telephone disclosure of BRCA1/2 test results may not be associated with negative cognitive and affective responses among willing patients, although some subgroups may experience less favorable responses. Some patients do not return for in-person clinical follow-up and longitudinal outcomes are unknown.


CONCLUSIONS
Further evaluation of longitudinal outcomes of telephone disclosure and differences among subgroups can inform how to best incorporate telephone communication into delivery of genetic services.
Department of Medicine, Division of Hematology-Oncology, The University of Chicago, Chicago, USA; Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, USA.
Linda
L
Patrick-Miller
Brian L
BL
Egleston
Mary
M
Daly
Evelyn
E
Stevens
Dominique
D
Fetzer
Andrea
A
Forman
Lisa
L
Bealin
Christina
C
Rybak
Candace
C
Peterson
Melanie
M
Corbman
Angela R
AR
Bradbury
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics; D003142:Communication; D003863:Depression; D030881:Disclosure; D005240:Feasibility Studies; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000379:methods; D020022:Genetic Predisposition to Disease / Q000523:psychology; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D013689:Telephone
Cancer risk assessment; Cancer susceptibility; Communication; Genetic testing