caa a22 4500 605544158 CHVBK 20210128100930.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10897-014-9753-0 doi (NATIONALLICENCE)springer-10.1007/s10897-014-9753-0 Use of a Patient-Entered Family Health History Tool with Decision Support in Primary Care: Impact of Identification of Increased Risk Patients on Genetic Counseling Attendance [Elektronische Daten] [Adam Buchanan, Carol Christianson, Tiffany Himmel, Karen Powell, Astrid Agbaje, Geoffrey Ginsburg, Vincent Henrich, Lori Orlando] Several barriers inhibit collection and use of detailed family health history (FHH) in primary care. MeTree, a computer-based FHH intake and risk assessment tool with clinical decision support, was developed to overcome these barriers. Here, we describe the impact of MeTree on genetic counseling (GC) referrals and attendance. Non-adopted, English speaking adults scheduled for a well-visit in two community-based primary-care clinics were invited to participate in an Implementation-Effectiveness study of MeTree. Participants' demographic characteristics and beliefs were assessed at baseline. Immediately after an appointment with a patient for whom GC was recommended, clinicians indicated whether they referred the patient and, if not, why. The study genetic counselor kept a database of patients with a GC recommendation and contacted those with a referral. Of 542 patients completing MeTree, 156 (29%) received a GC recommendation. Of these, 46% (n = 72) were referred and 21% (n = 33) underwent counseling. Patient preferences, additional clinical information unavailable to MeTree, and an incomplete clinician evaluation of the FHH accounted for the 85 patients clinicians chose not to refer. Although MeTree identified a significant proportion of patients for whom GC was recommended, persistent barriers indicate the need for improved referral processes and patient and physician education about the benefits of GC. National Society of Genetic Counselors, Inc., 2014 Personalized medicine nationallicence Family history nationallicence Primary care providers nationallicence Referral nationallicence Genetic counseling nationallicence Buchanan Adam Duke Cancer Institute, Duke University, DUMC 2715 2424 Erwin Rd., Suite 602, 27705, Durham, NC, USA aut Christianson Carol The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut Himmel Tiffany Duke Institute for Genome Sciences & Policy, Duke University, Durham, NC, USA aut Powell Karen The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut Agbaje Astrid Moses Cone Health System, Greensboro, NC, USA aut Ginsburg Geoffrey Duke Institute for Genome Sciences & Policy, Duke University, Durham, NC, USA aut Henrich Vincent The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut Orlando Lori Department of Medicine, Duke University, Durham, NC, USA aut Journal of Genetic Counseling Springer US; http://www.springer-ny.com 24/1(2015-02-01), 179-188 1059-7700 24:1<179 2015 24 10897 https://doi.org/10.1007/s10897-014-9753-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10897-014-9753-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Buchanan Adam Duke Cancer Institute, Duke University, DUMC 2715 2424 Erwin Rd., Suite 602, 27705, Durham, NC, USA aut NATIONALLICENCE 700 1- Christianson Carol The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut NATIONALLICENCE 700 1- Himmel Tiffany Duke Institute for Genome Sciences & Policy, Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- Powell Karen The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut NATIONALLICENCE 700 1- Agbaje Astrid Moses Cone Health System, Greensboro, NC, USA aut NATIONALLICENCE 700 1- Ginsburg Geoffrey Duke Institute for Genome Sciences & Policy, Duke University, Durham, NC, USA aut NATIONALLICENCE 700 1- Henrich Vincent The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro, Greensboro, NC, USA aut NATIONALLICENCE 700 1- Orlando Lori Department of Medicine, Duke University, Durham, NC, USA aut NATIONALLICENCE 773 0- Journal of Genetic Counseling Springer US; http://www.springer-ny.com 24/1(2015-02-01), 179-188 1059-7700 24:1<179 2015 24 10897