JL421. Review of a Genetic Risk Assessment Delivery Model in a Private Community Oncology Practice
Doreen Grzelak, NP-C, CBCN, MSN, AOCN®, Virginia Cancer Specialists, Washington, DC
According to the Oncology Nursing Society (ONS), part of the advanced practice nurse (APN) role is to provide genetic and genomic care to individuals in conjunction with expert providers (ONS, 2012). This is a review of a genetic risk assessment program in a private community oncology practice. The delivery model utilized includes physicians, an APN and a genetic counselor. Data was reviewed retrospectively from the inception of the program in 2011 through 2015. In addition to reviewing the number of patients seen, data was analyzed to determine the most frequent diagnosis, as well as results of genetic testing. We found that there was a need for this service for current patients in our practice and affected individuals in the community, as well as individuals in the community who were unaffected but had a family history of cancer. In 2014 and 2015 over one half of those seen were referred from outside of the practice. As expected, the most frequent diagnosis of those counseled was breast cancer. The second largest group was unaffected individuals seeking counseling based on family history. Additionally, as expected with the advent of panel testing, our results revealed an increase in variants of uncertain significance (VUSs). As the knowledge of genetic information continues to evolve, changes to guidelines for testing of individuals with cancer continues to expand. We anticipate the demand for genetic counseling to increase. The use of qualified non-genetic counselors in conjunction with genetic counselors in private community oncology practice is a delivery model that provides a needed service for oncology patients and their families. As a result, advanced practitioners (APs) will need to find methods to remain updated on recommendations for genetic risk assessment to provide counseling or refer patients appropriately.
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