Purpose To examine the benefit of telehealth over current delivery options in oncology practices without genetic counselors. Methods Participants meeting cancer genetic testing guidelines were recruited to this multi‐center, randomized trial comparing uptake of genetic services with remote services (telephone or videoconference) to usual care in six predominantly community practices without genetic counselors. The primary outcome was the composite uptake of genetic counseling or testing. Secondary outcomes compare telephone versus videoconference services. Results 147 participants enrolled and 119 were randomized. Eighty percent of participants in the telehealth arm had genetic services as compared to 16% in the usual care arm (OR 30.52, p < 0.001). Five genetic mutation carriers (6.7%) were identified in the telehealth arm, compared to none in the usual care arm. In secondary analyses, factors associated with uptake were lower anxiety (6.77 vs. 8.07, p = 0.04) and lower depression (3.38 vs. 5.06, p = 0.04) among those who had genetic services. There were no significant differences in change in cognitive or affective outcomes immediately post‐counseling and at 6 and 12 months between telephone and videoconference arms. Conclusion Telehealth increases uptake of genetic counseling and testing at oncology practices without genetic counselors and could significantly improve identification of genetic carriers and cancer prevention outcomes.

Objective: The aim of study was to assess hospital phobia and its variation of depressive symptoms in primary care population. Introduction: Nosocomephobia is the fear of hospitals. It is a fairly common phobia; many people are known to suffer from it. Like that “If I go to a hospital, I’m fairly sure it is a fact that my life is not guaranteed.” Patients are afraid of hospitals, especially the emergency rooms. Hospitals are the mark of cure and health. They even usually result in huge expenses. Most people understand that it is a medical necessity and that one does not and fear must be overcome in case of Nosocomephobia though, the patient simply refuses to go to a hospital and the result often are not desirable including death especially in case of major life threatening conditions. Results: In Primary Care population (PCP) severity of Hospital-phobia is very high. Patients show different depressive symptoms like nausea, loss of appetite, mood swing etc. The result of survey shows that insomnia is the highest number found in depressive patients which is approximately 50% in male patients alone. Female the percentage is slightly low i.e. approximately 40%. Discussion and Conclusion: A survey has been conducted at Karachi to ascertain how many people are suffering from hospital phobia. Our survey result showed that the hospital fear (nosocomephobia) is very common in the biggest city of Pakistan i.e. Karachi. The best way to overcome the nosocomephobia is to change the mindset of the patient through some self-help techniques.