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Call Genetic Counselors, Maybe?

The steady rise of the numbers of genetic tests being used in clinical care, the ever-expanding number of known functional genetic markers, and the possibility that whole-genome sequencing may be used more widely in treatment, all suggest that there may be a need for more genetic counselors.

Telephone consultations could make it easier for patients and consumers to get more information about what tests and results mean, and these tele-sessions are likely just as effective as face-to-face visits, a new study says. It also could save money.

Researchers at the Georgetown Lombardi Comprehensive Cancer Center and partnering institutions compared telephone consultations with in-person meetings for 669 women who are considering testing for BRCA1 and BRCA2 status

In their paper in the Journal of Clinical Oncology, the authors say telephone-based counseling could extend genetic counselors' capability to provide comprehensive counseling, but that it has been a "controversial" practice because of concerns about how much the patients and consumers comprehend. Still, most genetic counselors have already provided BRCA-status results via telephone, and 23 percent have provided pre-test counseling.

"It's important that all people interested in testing have access to thorough information so they can consider the implications of test results and interpret them in the context of family history," Georgetown's Marc Schwartz says in a statement.

The authors say they found that telephone counseling is just as useful as face-to-face visits for all of the test outcomes, although telephone counseling did yield a lower rate of people who chose to take the tests than did the usual care.

Still, the authors say the study offers strong evidence that genetic counseling can be performed via telephone.

"We found no evidence that [telephone calls] led to higher distress, lower satisfaction, or lower comprehension than [in-person sessions]. [Telephone visits] also led to a cost savings of $114 per patient up to $321 per patient for those who live farther from a clinic and who provide DNA via in-home buccal sampling," they note.

Schwartz also says phone consultations make it easier for people living in rural areas to access counseling and genetic tests.

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