lunes, 11 de febrero de 2019

A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer: A pilot randomized controlled t... - PubMed - NCBI

2019 Feb 1. pii: S0090-8258(19)30062-9. doi: 10.1016/j.ygyno.2019.01.019. [Epub ahead of print]

A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer: A pilot randomized controlled trial.

Vogel RI1, Niendorf K2, Petzel S1, Lee H1, Teoh D1, Blaes AH3, Argenta P1, Rivard C1, Winterhoff B1, Lee HY4, Geller MA5.

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Abstract

OBJECTIVE:

Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for GeneticInformation on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling.

METHODS:

The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services.

RESULTS:

Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0-10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96% of women in the intervention group reported they had talked with their family about genetic counseling compared to 77% in the control group (p = 0.01).

CONCLUSIONS:

The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants' knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862.