title: Primary-care providers' perceived barriers to integration of genetics services: a systematic review of the literature.
abstract: OBJECTIVE
  We aimed to systematically review the literature to identify primary-care providers' perceived barriers against provision of genetics services.
  
  
  METHODS
  We systematically searched PubMed and ERIC using key and Boolean term combinations for articles published from 2001 to 2012 that met inclusion/exclusion criteria. Specific barriers were identified and aggregated into categories based on topic similarity. These categories were then grouped into themes.
  
  
  RESULTS
  Of the 4,174 citations identified by the search, 38 publications met inclusion criteria. There were 311 unique barriers that were classified into 38 categories across 4 themes: knowledge and skills; ethical, legal, and social implications; health-care systems; and scientific evidence. Barriers most frequently mentioned by primary-care providers included a lack of knowledge about genetics and genetic risk assessment, concern for patient anxiety, a lack of access to genetics, and a lack of time.
  
  
  CONCLUSIONS
  Although studies reported that primary-care providers perceive genetics as being important, barriers to the integration of genetics medicine into routine patient care were identified. The promotion of practical guidelines, point-of-care risk assessment tools, tailored educational tools, and other systems-level strategies will assist primary-care providers in providing genetics services for their patients.
authors.affiliation: American Academy of Pediatrics, Elk Grove Village, Illinois, USA.
authors.forename: Natalie A
authors.identifier: 000000030318344X
authors.initials: NA
authors.lastname: Mikat-Stevens
authors.affiliation: Division of General Pediatrics, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA.
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Larson
authors.affiliation: Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Tarini
mesh_terms: D033142:Genetic Services; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D058007:Physicians, Primary Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'