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Randomized Trial of Telegenetics vs. In‐Person Cancer Genetic Counseling: Cost, Patient Satisfaction and Attendance
Author(s) -
Buchanan Adam H.,
Datta Santanu K.,
Skinner Celette Sugg,
Hollowell Gail P.,
Beresford Henry F.,
Freeland Thomas,
Rogers Benjamin,
Boling John,
Marcom P. Kelly,
Adams Martha B.
Publication year - 2015
Publication title -
journal of genetic counseling
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 52
eISSN - 1573-3599
pISSN - 1059-7700
DOI - 10.1007/s10897-015-9836-6
Subject(s) - genetic counseling , attendance , randomized controlled trial , medicine , patient satisfaction , public health , cancer , family medicine , quality of life research , physical therapy , clinical psychology , nursing , genetics , economics , biology , economic growth
Telegenetics—genetic counseling via live videoconferencing—can improve access to cancer genetic counseling (CGC) in underserved areas, but studies on cancer telegenetics have not applied randomized methodology or assessed cost. We report cost, patient satisfaction and CGC attendance from a randomized trial comparing telegenetics with in‐person CGC among individuals referred to CGC in four rural oncology clinics. Participants ( n = 162) were randomized to receive CGC at their local oncology clinic in‐person or via telegenetics. Cost analyses included telegenetics system; mileage; and personnel costs for genetic counselor, IT specialist, and clinic personnel. CGC attendance was tracked via study database. Patient satisfaction was assessed 1 week post‐CGC via telephone survey using validated scales. Total costs were $106 per telegenetics patient and $244 per in‐person patient. Patient satisfaction did not differ by group on either satisfaction scale. In‐person patients were significantly more likely to attend CGC than telegenetics patients (89 vs. 79 %, p = 0.03), with bivariate analyses showing an association between lesser computer comfort and lower attendance rate (Chi‐square = 5.49, p = 0.02). Our randomized trial of telegenetics vs. in‐person counseling found that telegenetics cost less than in‐person counseling, with high satisfaction among those who attended. This study provides support for future randomized trials comparing multiple service delivery models on longer‐term psychosocial and behavioral outcomes.