What is the Experience of Family Physicians Regarding Patient s Clinical Genetic Questions?

Transcription

1 What is the Experience of Family Physicians Regarding Patient s Clinical Genetic Questions? Rick Kellerman, MD, John Dorsch, MD, Doug Woolley, MD, MPH, Terry Ast, BA Department of Family and Community Medicine Location of Survey Participants 1

2 Results # of Surveys sent: 283 # of Surveys returned: 175 Return rate: 62% 34% by 28% by regular mail. Did not respond to 38% either method Age Years in Practice Mean SD

3 Do you provide prenatal healthcare? No Yes In the last 12 months have you had a patient request and have you ordered a genetic DNA test for: 3 25% 15% 5% Paternity Testing BRCA Requested Ordered Colon CA Alzheimers Cystic Fibrosis 3

4 In the last 12 months have you used any online clinical reference resource to research a patient's clinical genetic problem? 10 95% 9 85% 8 75% 7 65% 6 55% 5 45% 4 35% 3 25% 15% 5% Often Sometimes Seldom Never Are you aware of the wwwgeneclinics.org website? NO Yes 4

5 If so, have you used the wwwgeneclinicsorg website? NO Yes n = 14 Continuing medical education on genetic DNA testing is of what priority to you? High Medium Low 5

6 List up to three clinical genetic BRCA (23) Ovarian cancer (10) Cystic fibrosis (8) Alzhiemers risk (7) Colon Cancer risk (7) paternity testing (7) Down's syndrome-inheritance/life expectancy (6) Chances of acquiring certain diseases (4) Does Angelman s syndrome run in families; Does my patient have Angelman's Syndrome? (3) List up to three clinical genetic Huntington's risk (3) Sickle cell disease (2) Thalassemia (2) Hemochromatosis risk (2) Trisomy disorders (2) Klinefelter's evaluation (2) Asperger s syndrome Can insurance access genetic testing and deny care Genetics test for FLK 6

7 List up to three clinical genetic Concern for discrimination and inappropriate use of genetic information should be of highest priority. Depression risk Diabetes risk Factor V Leider Familial cancer Family history of clotting disorder Family Hx of Macular Degeneration Fragile x syndrome Genetic links to cholesterol elevation. Hereditary risk of lymphoma List up to three clinical genetic Maple syrup urine disease Neurofibromatosis History CP carrier in family - tested. Impact of genetics on cholesterol Impact of genetics on heart disease Inflammatory Bowel Disease Is congenital pulmonic stenosis passed to offspring? Is my patient a carrier of MCADD? Is my patient a hemophilia carrier? 7

8 List up to three clinical genetic Risk of congenital deafness in subsequent offspring. Risk of passing Hgbc to offspring and should they be re screened? Newborn with anomalies-genetic syndrome? Obesity-Leptin Osteoporosis risk issues. Pregnancy, triple screen testing Probability of developing diabetes. Prognosis for infant with rare chromosomal abnormality Reason for RPL List up to three clinical genetic Seckel Syndrome Second cousins marrying. Should I perform genetic testing on baby born with 2 vessel umbilical cord? Skin Cancer risk What are insurance rules of being labeled with abnormal gene? What is Lowes syndrome What tests are reasonable to consider ordering? Where do these tests fit in with preventive care? 8

9 Conclusion: Less than half of physicians who responded to the survey indicate they have received a request from patients to perform a genetic test. A third have ordered a genetic test. Paternity testing and breast cancer screening were the two most commonly requested and ordered genetic tests. Cystic fibrosis screening was ordered more frequently than requested. Conclusion: Currently, family physicians in Kansas do not feel pressure from their patient care responsibilities to make continuing medical education in genomics a high priority. may be an efficient way to conduct short on-line surveys of Kansas physicians. 9