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Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results...

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Autores principales: Williams, Janet L., Rahm, Alanna Kulchak, Zallen, Doris T., Stuckey, Heather, Fultz, Kara, Fan, Audrey L., Bonhag, Michele, Feldman, Lynn, Segal, Michael M., Williams, Marc S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859697/
https://www.ncbi.nlm.nih.gov/pubmed/29204811
http://dx.doi.org/10.1007/s10897-017-0176-6
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author Williams, Janet L.
Rahm, Alanna Kulchak
Zallen, Doris T.
Stuckey, Heather
Fultz, Kara
Fan, Audrey L.
Bonhag, Michele
Feldman, Lynn
Segal, Michael M.
Williams, Marc S.
author_facet Williams, Janet L.
Rahm, Alanna Kulchak
Zallen, Doris T.
Stuckey, Heather
Fultz, Kara
Fan, Audrey L.
Bonhag, Michele
Feldman, Lynn
Segal, Michael M.
Williams, Marc S.
author_sort Williams, Janet L.
collection PubMed
description “The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS™, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS™ report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS™ reports were released to 14 families (N = 28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N = 24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS™ reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS™ report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10897-017-0176-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-58596972018-03-22 Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication Williams, Janet L. Rahm, Alanna Kulchak Zallen, Doris T. Stuckey, Heather Fultz, Kara Fan, Audrey L. Bonhag, Michele Feldman, Lynn Segal, Michael M. Williams, Marc S. J Genet Couns Original Research “The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS™, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS™ report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS™ reports were released to 14 families (N = 28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N = 24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS™ reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS™ report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10897-017-0176-6) contains supplementary material, which is available to authorized users. Springer US 2017-12-04 2018 /pmc/articles/PMC5859697/ /pubmed/29204811 http://dx.doi.org/10.1007/s10897-017-0176-6 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Williams, Janet L.
Rahm, Alanna Kulchak
Zallen, Doris T.
Stuckey, Heather
Fultz, Kara
Fan, Audrey L.
Bonhag, Michele
Feldman, Lynn
Segal, Michael M.
Williams, Marc S.
Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title_full Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title_fullStr Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title_full_unstemmed Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title_short Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication
title_sort impact of a patient-facing enhanced genomic results report to improve understanding, engagement, and communication
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859697/
https://www.ncbi.nlm.nih.gov/pubmed/29204811
http://dx.doi.org/10.1007/s10897-017-0176-6
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