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Randomized Noninferiority Trial of Telephone vs In-Person Genetic Counseling for Hereditary Breast and Ovarian Cancer: A 12-Month Follow-Up

Randomized Noninferiority Trial of Telephone vs In-Person Genetic Counseling for Hereditary Breast and Ovarian Cancer: A 12-Month Follow-Up


Title: Randomized Noninferiority Trial of Telephone vs In-Person Genetic Counseling for Hereditary Breast and Ovarian Cancer: A 12-Month Follow-Up
Author: Interrante, Mary K.
Segal, Hannah
Peshkin, Beth N.
Valdimarsdottir, Heiddis   orcid.org/0000-0001-9976-0007
Nusbaum, Rachel
Similuk, Morgan
DeMarco, Tiffani
Hooker, Gillian
Graves, Kristi
Isaacs, Claudine
... 7 more authors Show all authors
Date: 2017-09-01
Language: English
University/Institute: Háskólinn í Reykjavík
Reykjavik University
School: Viðskiptadeild (HR)
School of Business (RU)
Department: Sálfræði (HR)
Psychology (RU)
Series: JNCI Cancer Spectrum;1(1)
ISSN: 2515-5091 (eISSN)
DOI: 10.1093/jncics/pkx002
Subject: Female; Breast cancer; Ovarian cancer; Genetic counseling; Telephone counseling; Patient satisfaction; Konur; Brjóstakrabbamein; Eggjastokkar; Krabbamein; Erfðaráðgjöf; Sjúklingafræðsla; Ráðgjöf; Símtöl; Sjúklingar; Ánægja
URI: https://hdl.handle.net/20.500.11815/1510

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Citation:

Interrante, M. K., Segal, H., Peshkin, B. N., Valdimarsdottir, H. B., Nusbaum, R., Similuk, M., DeMarco, T., Hooker, G., Graves, K., Isaacs, C., Wood, M., McKinnon, W., Garber, J., McCormick, S., Heinzmann, J., Kinney, A. Y., & Schwartz, M. D. (2017). Randomized Noninferiority Trial of Telephone vs In-Person Genetic Counseling for Hereditary Breast and Ovarian Cancer: A 12-Month Follow-Up. Jnci Cancer Spectrum, 1(1), UNSP pkx002. https://doi.org/10.1093/jncics/pkx002

Abstract:

Background: Telephone delivery of genetic counseling is an alternative to in-person genetic counseling because it may extend the reach of genetic counseling. Previous reports have established the noninferiority of telephone counseling on short-term psychosocial and decision-making outcomes. Here we examine the long-term impact of telephone counseling (TC) vs inperson counseling (usual care [UC]). Methods: We recruited high-risk women for a noninferiority trial comparing TC with UC. Of 1057 potentially eligible women, 669 were randomly assigned to TC (n = 335) or UC (n = 334), and 512 completed the 12-month follow-up. Primary outcomes were patient-reported satisfaction with genetic testing decision, distress, and quality of life. Secondary outcomes were uptake of cancer risk management strategies. Results: TC was noninferior to UC on all primary outcomes. Satisfaction with decision (d = 0.13, lower bound of 97.5% confidence interval [CI] = -0.34) did not cross its one-point noninferiority limit, cancer-specific distress (d = -2.10, upper bound of 97.5% CI = -0.07) did not cross its four-point noninferiority limit, and genetic testing distress (d = -0.27, upper bound of 97.5% CI = 1.46), physical function (d = 0.44, lower bound of 97.5% CI = -0.91) and mental function (d = -0.04, lower bound of 97.5% CI = -1.44) did not cross their 2.5-point noninferiority limit. Bivariate analyses showed no differences in risk-reducing mastectomy or oophorectomy across groups; however, when combined, TC had significantly more risk-reducing surgeries than UC (17.8% vs 10.5%; chi(2) = 4.43, P = .04). Conclusions: Findings support telephone delivery of genetic counseling to extend the accessibility of this service without long-termadverse outcomes.

Rights:

© The Author 2017. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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