Transition to telephone genetic counseling services during the COVID-19 pandemic
Transition to telephone genetic counseling services during the COVID-19 pandemic
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DOI：
10.1002/jgc4.1365
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发表时间：
2020-12-04
影响因子：
1.9
通讯作者：
Seidel, Meredith L.
中科院分区：
文献类型：
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作者：
Shannon, Kristen M.;Emmet, Margaret M.;Seidel, Meredith L.
COVID-19大流行严重扰乱了包括肿瘤学在内的医疗服务的提供。为了确保大型学术医疗中心癌症遗传咨询的连续性，同时促进患者和工作人员的安全，我们的团队在48小时内过渡到完全远程电话遗传咨询和检测服务。我们比较了转移到电话遗传咨询后六周（COVID后）与大流行前六周（COVID前）的差异。我们保持了99%的总就诊能力，患者未就诊率从9.5%下降到7.3%。在所有接受电话遗传咨询的患者中，与疫情前亲自就诊的患者相比，同意接受基因检测的患者较少（COVID前为79%，COVID后为72%; p= 0.012）。在该队列关闭分析四周后，303个样本中有96个（32%）没有被基因检测实验室收到，尽管至少有一个提醒电话给患者。在13例报告的情况下，需要第二份样本（质量不合格、样本丢失或标签错误），因此延迟了检测结果。我们的结论是，在COVID-19大流行期间，快速过渡到远程遗传咨询和检测允许不间断地获得癌症遗传学服务。患者对样本返回的依从性和较高的样本失败率成为这种服务提供模式下及时进行基因检测的潜在障碍。
The COVID-19 pandemic has significantly disrupted the delivery of healthcare services, including oncology. To ensure continuity of cancer genetic counseling at a large academic medical center while also promoting the safety of patients and staff, our team transitioned to fully remote telephone genetic counseling and testing services within 48 hr. We compare differences in the six weeks following the shift to telephone genetic counseling (post-COVID) to the six weeks preceding the pandemic (pre-COVID). We maintained 99% of our total visit capacity and saw a decrease in patient no-show rate from 9.5% to 7.3%. Of all patients who received telephone genetic counseling, fewer consented to genetic testing as compared to patients seen in-person prior to the pandemic (79% pre-COVID v. 72% post-COVID; p=.012). Four weeks after this cohort was closed for analysis, 96 out of 303 samples (32%) had not been received by the genetic testing laboratory, despite at least one reminder phone call to the patient. In 13 reported instances, a second sample was required (quality not sufficient, lost or mislabeled sample), thus delaying test results. We conclude that a rapid transition to remote genetic counseling and testing allowed uninterrupted access to cancer genetics services during to the COVID-19 pandemic. Patient compliance with sample return and higher rates of sample failure emerge as potential barriers to timely genetic testing under this service delivery model.