Genetics in clinical practice: general practitioners' educational priorities in European countries

Julian‐Reynier, Claire; Nippert, Irma; Calefato, Jean-Marc; Harris, Herbert I.; Kristoffersson, Ulf; Schmidtke, J.; Kate, Leo ten; Anionwu, Elizabeth; Benjamin, Caroline; Challen, Kirsty; Plass, Anne Marie; Harris, Rodney

doi:10.1097/gim.0b013e3181616693

Cited by 30 publications

(31 citation statements)

References 22 publications

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“…So far, several articles describing in depth sampling, methodology and response rates, presenting results from other parts of the survey, have been published (Challen et al 2005;Calefato et al 2008;Julian-Reynier et al 2008;Benjamin et al 2009;Plass et al 2009). One of the major objectives of the GenEd survey was to address the confidence of primary care physicians in their ability to carry out basic medical genetic tasks.…”

Section: Objectives and Methodsmentioning

confidence: 97%

Confidence of primary care physicians in their ability to carry out basic medical genetic tasks—a European survey in five countries—Part 1

et al. 2010

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Western health care systems are facing today increasing movement of genetic knowledge from research labs into clinical practice. This paper reports the results of a survey that addressed the confidence of primary care physicians in their ability to carry out basic medical genetic tasks. The survey was conducted in five countries (France, Germany, The Netherlands, Sweden and the UK). Stratified random samples were drawn from primary care physicians in the five countries representing a sampling frame of 139,579 physicians. Stepwise binary logistic regression procedures were performed to identify the predictor variables for self-reported confidence. Three thousand six hundred eighty-six physicians participated and filled out a self-administered questionnaire. The margin of error for accurate representation of each group of European general practitioners and specialists in the total sample is 2.9% for GP, 2.8% for obstetricians/gynaecologists (OB/GYN) and for paediatricians (PAED) 2.6% (95% confidence level). Confidence in their ability to carry out basic medical genetic tasks is low among participating primary care physicians: 44.2% are not confident, 36.5% somewhat confident, confident or very confident are 19.3%. In each country, those confident/very confident represent less than 33% of the participating physicians. Primary care physicians who report the lowest levels of confidence prove to be those least exposed to medical genetics information and training. Although there are significant differences in the way in which professional education is organised and practice is regulated across European countries, there is a need for a coordinated European effort to improve primary care physicians' background in medical genetics.

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Section: Objectives and Methodsmentioning

confidence: 97%

Confidence of primary care physicians in their ability to carry out basic medical genetic tasks—a European survey in five countries—Part 1

et al. 2010

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“…[27][28][29][30] Seminar attendance was high but a difference in overall referrals might have been identified if more GPs had received the intervention. Face-to-face educational interventions were found to have greater impact on referral patterns than postal educational packs alone or non-practicebased education such as computer software support, as evaluated by Wilson et al 10 There was a trend of increased overall referrals in the first year, but after this both groups had similar referral rates.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

A primary care specialist genetics service: a cluster-randomised factorial trial

Westwood

Pickering²,

Latter³

et al. 2012

Br J Gen Pract

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BackgroundGPs do not have the confidence to identify patients at increased genetic risk. A specialist primary care clinical genetics service could support GPs with referral and provide local clinics for their patients. AimTo test whether primary care genetic-led genetics education improves both non-cancer and cancer referral rates, and primary care-led genetics clinics improve the patient pathway. Design and settingCluster-randomised factorial trial in 73 general practices in the south of England. MethodPractices randomised to receive case scenario based seminar (intervention) or not (control), and referred patients a primary (intervention) or secondary (control) care genetic counsellor (GC)-led appointment. Outcome measures: GP referral and clinic attendance rates (primary), appropriate cancer and case scenario referral rates, patient satisfaction, clinic costs, and case management (secondary). ResultsEighty-nine and 68 referrals made by 36 intervention and 37 control practices respectively. There was a trend towards an overall higher referral rate among educated GPs (referral rate ratio [RRR] 1.34, 95% confidence interval [CI] = 0.89 to 2.02; P = 0.161), and they made more appropriate cancer referrals (RRR 2.36, 95% CI = 1.07 to 5.24; P = 0.035). No indication of difference in clinic attendance rates (odds ratio 0.91, 95% CI = 0.43 to 1.95; P = 0.802) or patient satisfaction (P = 0.189). Patients spent 49% less travelling (£3.60 versus £6.62; P<0.001) and took 33% less time (39.7 versus 57.7 minutes; P<0.001) to attend a primary than secondary care appointment; 83% of GC-managed appointments met the 18-week referral to treatment, NHS target. ConclusionAn integrated primary care genetics service both supports GPs in appropriate cancer referral and provides care in the right place by the right person.

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“…This study aims to explore how nongenetic health-care providers would react when confronted with a parent requesting presymptomatic genetic testing on a minor child for a treatable disease. The present study is part of a larger 5th EU-framework study in which genetic education (GenEd) for nongenetic health-care providers was investigated in two phases: Phase I of the GenEd project has provided evidence of the current policies relating to GenEd initially across five European countries with input from another six countries (Challen et al, 2005Harris et al, 2006;Henriksson and Kristoffersson, 2006;Julian-Reynier and Arnaud, 2006;Plass et al, 2006;Schmidtke et al, 2006); Phase II aimed to clarify professional needs by consulting nongeneticist health professionals ( Julian-Reynier et al, 2008). It is hoped to improve patient care by facilitating the appropriate use of genetic information within clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Testing the Children: Do Non-Genetic Health-Care Providers Differ in Their Decision to Advise Genetic Presymptomatic Testing on Minors? A Cross-Sectional Study in Five Countries in the European Union

Plass

Baars²,

Cornel

et al. 2009

Genetic Testing and Molecular Biomarkers

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Genetics in clinical practice: general practitioners' educational priorities in European countries

Cited by 30 publications

References 22 publications

Confidence of primary care physicians in their ability to carry out basic medical genetic tasks—a European survey in five countries—Part 1

Confidence of primary care physicians in their ability to carry out basic medical genetic tasks—a European survey in five countries—Part 1

A primary care specialist genetics service: a cluster-randomised factorial trial

Testing the Children: Do Non-Genetic Health-Care Providers Differ in Their Decision to Advise Genetic Presymptomatic Testing on Minors? A Cross-Sectional Study in Five Countries in the European Union

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