Hereditary Cancer Screening Attitudes and Practices Among Primary Care Providers PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download Hereditary Cancer Screening Attitudes and Practices Among Primary Care Providers PDF full book. Access full book title Hereditary Cancer Screening Attitudes and Practices Among Primary Care Providers by Sarah Lewandowski. Download full books in PDF and EPUB format.
Author: Sarah Lewandowski Publisher: ISBN: Category : Languages : en Pages : 63
Book Description
Across the United States nationally recommended strategies for identifying asymptomatic individuals with predispositions to hereditary cancer syndromes are severely underutilized. The long term doctor-patient relationship between primary care providers (PCPs) and their patients makes them uniquely positioned to carry out such testing, but historically PCPs report being unknowledgeable about these topics. This study aims to 1) describe how much confidence PCPs have conducting clinical cancer consultations, 2) identify PCPs' current practices for obtaining their patients' personal and familial cancer histories, and to 3) understand how PCPs use their patients' personal and familial histories of cancer to inform their ordering of genetic testing. An online survey was distributed and follow up semi-structured interviews were conducted among a group of PCPs located throughout Washington, Wyoming, and Montana. Binary logistic regression analyses were used to explore the relationship between background variables and the PCPs' confidence scores. Interview transcripts were analyzed via a directed content analysis approach. The regression analyses showed that PCPs who practiced in more urban rural urban continuum codes (RUCC) and scored higher on the Consolidated Framework for Implementation Research (CFIR) self-efficacy subscale were more likely to have higher confidence levels with respect to initiating the conversation about cancer risk and responding to their patients' questions about cancer risk based on their family history, as well as their confidence in explaining lifetime and age-related cancer risk to their patients. The interview results revealed that most PCPs gather personal and familial cancer history from their patients via a general direct questioning process with the patient in tandem with another method. Most PCPs believe that collecting this information is important primarily because it informs their future cancer screening recommendation. Most PCPs are not ordering cancer risk genetic testing and those that are report they are really only comfortable ordering rather limited range of cancer genetic tests. Conclusions: These results suggest that PCPs recognize the benefits these early identification strategies can provide, but they don’t feel comfortable carrying out the ordering and interpretation of cancer risk genetic testing themselves. On this basis, better educational strategies, alongside implementation of updated procedures and automated prompts in electronic medical records are needed to further aid PCPs in successfully implementing universal screening and testing for predispositions to hereditary cancers in primary care settings.
Author: Sarah Lewandowski Publisher: ISBN: Category : Languages : en Pages : 63
Book Description
Across the United States nationally recommended strategies for identifying asymptomatic individuals with predispositions to hereditary cancer syndromes are severely underutilized. The long term doctor-patient relationship between primary care providers (PCPs) and their patients makes them uniquely positioned to carry out such testing, but historically PCPs report being unknowledgeable about these topics. This study aims to 1) describe how much confidence PCPs have conducting clinical cancer consultations, 2) identify PCPs' current practices for obtaining their patients' personal and familial cancer histories, and to 3) understand how PCPs use their patients' personal and familial histories of cancer to inform their ordering of genetic testing. An online survey was distributed and follow up semi-structured interviews were conducted among a group of PCPs located throughout Washington, Wyoming, and Montana. Binary logistic regression analyses were used to explore the relationship between background variables and the PCPs' confidence scores. Interview transcripts were analyzed via a directed content analysis approach. The regression analyses showed that PCPs who practiced in more urban rural urban continuum codes (RUCC) and scored higher on the Consolidated Framework for Implementation Research (CFIR) self-efficacy subscale were more likely to have higher confidence levels with respect to initiating the conversation about cancer risk and responding to their patients' questions about cancer risk based on their family history, as well as their confidence in explaining lifetime and age-related cancer risk to their patients. The interview results revealed that most PCPs gather personal and familial cancer history from their patients via a general direct questioning process with the patient in tandem with another method. Most PCPs believe that collecting this information is important primarily because it informs their future cancer screening recommendation. Most PCPs are not ordering cancer risk genetic testing and those that are report they are really only comfortable ordering rather limited range of cancer genetic tests. Conclusions: These results suggest that PCPs recognize the benefits these early identification strategies can provide, but they don’t feel comfortable carrying out the ordering and interpretation of cancer risk genetic testing themselves. On this basis, better educational strategies, alongside implementation of updated procedures and automated prompts in electronic medical records are needed to further aid PCPs in successfully implementing universal screening and testing for predispositions to hereditary cancers in primary care settings.
Author: Chris Jacobs Publisher: Oxford University Press, USA ISBN: 0199672849 Category : Medical Languages : en Pages : 363
Book Description
Genetics for Health Professionals in Cancer Care equips health professionals with the knowledge and skills required for all aspects of managing cancer family history, including discussing the challenges raised, and provides practical guidance on setting up a cancer family history clinic in primary and secondary care.
Author: Christine Krekel Publisher: ISBN: Category : Languages : en Pages : 52
Book Description
PURPOSE: To compare physician referral practices and attitudes for hereditary breast cancer between clinical practice locations: urban, suburban, and rural. METHODS: 214 physicians in Southwest Ohio's Tristate Region completed a self-administered questionnaire to assess referral practices and attitudes for hereditary breast cancer. Respondents were randomly sampled and grouped retrospectively into clinical practice location groups based on self-reported descriptor of practice location: suburban (39%), rural (32%), and urban (17%). Physician medical specialties included family practice, general practice, general surgery, internal medicine, obstetrics/gynecology, and oncology. RESULTS: Rural-practice physicians were less likely to have ever referred for hereditary breast cancer than suburban-practice physicians. Rural practice physicians were more likely to refer to an oncologist for this indication, whereas urban-practice physicians were more likely to refer to a genetic counselor. Rural practice physicians reported stronger barriers to referral, including distance to services and lack of awareness of services. Of all physicians who reported never referring, 61% reported having no need for such services, irrespective of clinical practice location. CONCLUSIONS: Women residing in rural areas are less likely to be referred for genetic services regarding hereditary breast cancer than their suburban counterparts. The reduced referral frequency among rural-practice physicians is partly due to increased barriers to referral. A significant proportion of physicians, regardless of practice location, may not recognize the benefit of genetic counseling and testing for hereditary breast cancer. Further studies are needed to investigate factors that influence physician referral for this indication, and that may vary by clinical practice location, including specialty, physician knowledge, and patient interest, and to assess the perceived value of genetic services among all physicians.
Author: Lisa T. Tieu Publisher: ISBN: Category : Languages : en Pages : 17
Book Description
The purpose of this practice improvement project was to evaluate a primary care clinic's implementation of the National Comprehensive Cancer Network's (NCCN) genetic testing guidelines for hereditary breast and/or ovarian cancer, and to make recommendations based on the clinic's needs. The primary focus was on breast cancer rather than the HBOC syndrome. This project utilized a survey from the National Cancer Institute to determine the clinic's attitudes and current practice on hereditary risk assessment. An educational component and a key ring of references were developed from the assessment. The key ring was designed to serve as an ongoing resource. A post-survey was conducted 10 weeks following implementation to re-evaluate the clinic's knowledge. The educational intervention increased provider knowledge and improved their breast cancer risk assessment. Implications for practice Nurse practitioners (NP) need to familiarize themselves with the American Nurses Association's genetic and genomic competencies to manage individuals with hereditary cancer syndromes. Identification, management, and establishing referral for genetic conditions are necessary in improving patient care regardless of the NP's specialty. Developing an educational program that meets the individual needs of a clinic can be successful in improving knowledge about BRCA risk assessment.
Author: Cynthia Chesy Publisher: ISBN: Category : Languages : en Pages :
Book Description
Statement of Problem: The current recommendations by the United States Preventive Services Task Force (USPSTF) regarding 'no cost sharing' genetic screening and chemo-preventive medications only for high risk women with breast cancer, in tandem with recommendations cover mammograms at 'no cost' sharing' biennially for low to moderate risk women 50 through 74, will contribute to another rise in breast cancer deaths among women. This problem is compounded by the non-uniformity by which primary care providers refer high risk women to a specialist for a more tailored assessment of personal risk factors/screening options, including the 'no cost sharing' preventative measures for high risk women that the USPSTF does endorse, namely genetic testing/counseling and risk-reducing medications for specific high risk women. The implementation of USPSTF guidelines will require the application of comprehensive, quantitative breast cancer risk assessments in primary care facilities across the country. However, the information about the feasibility and effect of individualized risk assessment in the primary care setting is limited (Anderson et al., 2015). Available evidence suggests this is not standard practice for U.S. primary care providers (Anderson et al., 2015). This study will help identify the key variables that contribute to the non-uniform referral pattern of high risk women for genetic testing and chemo-preventive medications in the U.S. This researcher will study the education of primary care providers and how this effects referrals for risk-reducing medications and/or genetic counseling services. The population of interest for this study will be a group of nurse practitioner students enrolled in an advanced practice care of women class at a local university in San Diego County. They will be provided with information regarding high-risk factors for breast cancer, and preventative 'no cost sharing' options that are offered under USPSTF guidelines. This researcher will look at the effects of a single session educational program on the students' knowledge of breast cancer risk factors and screening options for high risk women. Preventative methods targeted in this study will include genetic counseling and risk reducing medications. MRI for high-risk women and women with dense breasts will be presented as a screening option, but it will be made clear that this is not a 'no cost sharing' benefit. The educational intervention and survey tool will be modeled on the intervention and tool used in a 2015 study by Bryan et al., which assessed the impact of an educational intervention on provider knowledge, attitudes and comfort level regarding counseling about breast cancer screening. Bryan et al.'s educational intervention included a review of the risks and benefits of screening women ages 40-49, individual risk assessment, and counseling methods (Bryan, Estrada, Castiglioni, & Snyder, 2015).
Author: National Research Council Publisher: National Academies Press ISBN: 0309170133 Category : Medical Languages : en Pages : 564
Book Description
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: ISBN: 9780309685108 Category : Languages : en Pages : 448
Book Description
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
Author: Sarah Lewandowski
Author: Sarah Lewandowski
Author: Chris Jacobs
Author: Christine Krekel
Author: Frances M. Alexakos
Author: Lisa T. Tieu
Author: Carla Clasen
Author: Stacy A. Miller
Author: Cynthia Chesy
Author: National Research Council
Author: National Academies of Sciences, Engineering, and Medicine