Background: In order to recognize the value of genetic counselors, outside institutions such as third party payers require evidence that genetic counselors contribute to positive patient outcomes. Client adherence to medical management outcomes has not been previously studied as a possible outcome of genetic counseling. Patient adherence may result in improved medical outcomes.
Objectives: To determine if the inclusion of a genetic counselor in a patient’s initial genetics visit impacted patient adherence to medical management recommendations, by comparing the mean number of medical management recommendations completed by patients when a genetic counselor (GC) was involved in the patient’s initial visit versus when only genetics physicians were involved.
Secondarily, to determine if the GC and non-GC groups differ by number of days between a patient’s test results being finalized and the patient receiving the test results. And, to determine if the number of concepts recorded in the psychosocial section of the medical intake form following an initial visit to a general genetics clinic differ between the GC and non-GC groups.
Methods: This retrospective chart review included 198 pediatric patients seen for their initial visit at general genetics clinic at Cincinnati Children’s Hospital Medical Center in 2008. Half were seen only by a geneticist and/or genetics resident (the non-GC group) and half were seen by a geneticist and a genetic counselor (the GC-group). Medical management recommendations from the initial visits and evidence of adherence to those recommendations were abstracted from the medical record; adherence rates were compared between the GC and non-GC groups.
For the secondary outcomes, dates and test types were abstracted from results of tests completed at the initial visit, and concept types were coded from the psychosocial section of the intake form. The GC and non-GC groups were compared by number of days between a test result being finalized and the patient receiving the test results, and the number of concepts recorded in the psychosocial section of the medical intake form.
Results: Client adherence had a strong association with recommendation type; however, while type of management recommendation had a larger impact on adherence, involvement of a GC significantly improved adherence in all three management recommendation categories. For results that were reported to the family, genetic counselors and physicians in this study were equally timely in calling out test results. There was a non-significant trend in the number of psychosocial concepts recorded between the GC and non-GC groups, with the GC-group having slightly more concepts recorded.
Discussion: Involvement of a genetic counselor during an initial pediatric genetics visit may be associated with increased patient adherence. Further research is needed to determine if this association applies in other genetic counseling settings and if improved adherence results in improved medical outcomes.