A Rapid Systematic Review of Outcomes Studies in Genetic Counseling.
As healthcare reimbursement is increasingly tied to value-of-service, it is critical for the genetic counselor (GC) profession to demonstrate the value added by GCs through outcomes research. We conducted a rapid systematic literature review to identify outcomes of genetic counseling. Web of Science (including PubMed) and CINAHL databases were systematically searched to identify articles meeting the following criteria: 1) measures were assessed before and after genetic counseling (pre-post design) or comparisons were made between a GC group vs. a non-GC group (comparative cohort design); 2) genetic counseling outcomes could be assessed independently of genetic testing outcomes, and 3) genetic counseling was conducted by masters-level genetic counselors, or non-physician providers. Twenty-three papers met the inclusion criteria. The majority of studies were in the cancer genetic setting and the most commonly measured outcomes included knowledge, anxiety or distress, satisfaction, perceived risk, genetic testing (intentions or receipt), health behaviors, and decisional conflict. Results suggest that genetic counseling can lead to increased knowledge, perceived personal control, positive health behaviors, and improved risk perception accuracy as well as decreases in anxiety, cancer-related worry, and decisional conflict. However, further studies are needed to evaluate a wider array of outcomes in more diverse genetic counseling settings.
Moores UCSD Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92091-0901, USA. lmadlensky@ucsd.edu.
Lisa
L
Madlensky
Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
Angela M
AM
Trepanier
Department of Global Health, University of South Florida, Tampa, FL, USA.|Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Deborah
D
Cragun
Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
Barbara
B
Lerner
Mass General Cancer Center, Mass General Hospital, Boston, MA, USA.
Kristen M
KM
Shannon
Department of Genetics, Cell Biology, and Development, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
Heather
H
Zierhut
D000328:Adult; D001007:Anxiety; D002648:Child; D055088:Early Detection of Cancer; D005260:Female; D005817:Genetic Counseling / Q000523:psychology / Q000592:standards*; D005820:Genetic Testing; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D063868:Patient Outcome Assessment; D010549:Personal Satisfaction; D011247:Pregnancy
Genetic counseling; Outcomes; Review