Patient outcomes of genetic counseling: assessing the impact of different approaches to family history collection

No studies have evaluated whether different modalities for collection of family history data influence patient outcomes of genetic counseling. We retrospectively compared outcomes of genetic counseling between patients whose family history (Fhx) was collected: a) via telephone prior to their appointment (FhxPrior), or b) during the appointment (FhxDuring). We used a psychiatric genetic counseling clinic database, where information about demographics and Fhx timing is recorded and patients complete the Genetic Counseling Outcomes Scale (GCOS, measuring empowerment) and Illness Management Self-Efficacy Scale (IMSES) immediately prior to (T1) and one-month after their appointment (T2). We used ANCOVA to evaluate the effect of Fhx method on patient outcomes at T2. Complete data were available for 240 patients and were used for analysis (FhxPrior, n=206; FhxDuring, n=34). GCOS and IMSES scores increased from T1-T2 (p<0.0005, and p=0.004, respectively). Though there was no difference for GCOS (p=0.412), T2 IMSES scores were significantly higher for FhxPrior than FhxDuring after controlling for T1 scores (p=0.011). Our data suggest that obtaining Fhx via telephone prior to genetic counseling may lead to greater increases in patient self-efficacy as compared to obtaining Fhx during the genetic counseling appointment.

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