The Development and Evaluation of a Nationwide Training Program for Oncology Health Professionals in the Provision of Genetic Testing for Ovarian Cancer Patients

Affiliations

PMID: 32451123
DOI: 10.1016/j.ygyno.2020.05.001

Abstract

Background: BRCA1/2 mutation status has increasing relevance for ovarian cancer treatments, making traditional coordination of genetic testing by genetic services unsustainable. Consequently alternative models of genetic testing have been developed to improve testing at the initial diagnosis for all eligible women.

Methods: A training module to enable mainstreamed genetic testing by oncology healthcare professionals was developed by genetic health professionals. Oncology healthcare professionals completed questionnaires before and 12 months post-training to assess perceived skills, competence and barriers to their coordinating genetic testing for women with high-grade non-mucinous epithelial ovarian cancer. Genetic health professionals were surveyed 12 months post-training to assess perceived barriers to implementation of mainstreaming.

Results: 185 oncology healthcare professionals were trained in 42 workshops at 35 Australasian hospitals. Of the 273 tests ordered by oncology healthcare professionals post-training, 241 (93.1%) met national testing guidelines. The number of tests ordered by genetic health professionals reduced significantly (z = 45.0, p = 0.008). Oncology healthcare professionals' perceived barriers to mainstreamed testing decreased from baseline to follow-up (t = 2.39, p = 0.023), particularly perceived skills, knowledge and attitudes. However, only 58% reported either 'always' or 'nearly always' having ordered BRCA testing for eligible patients at 12 months, suggesting oncology healthcare professionals' perceived barriers were not systematically addressed through training.

Conclusions: Oncology healthcare professionals have demonstrated a willingness to be involved in the provision of genetic testing in a mainstreaming model. If oncology services are to hold responsibility for coordinating genetic testing, their readiness will require understanding of barriers not addressed by training alone to inform future intervention design.

Keywords: BRCA1/BRCA2; Genetic testing; Mainstreaming; Ovarian cancer.

Conflict of interest statement

Declaration of competing interest Bettina Meiser, Kathy Tucker, Maira Kentwell and Margaret Gleeson have held a remunerated consultant role with the company Astrazeneca with respect to this project and together with Michael Friedlander, Yoland Antill, Amy Pearn, Camron Ebzery and Rachel Williams have been remunerated by Astrazeneca for advisory boards and lectures outside this project. Amy Pearn has also held a position with the Genetic Services of Western Australia funded solely by Astrazeneca. Michael Friedlander and Yoland Antill have also received support for investigator initiated clinical trials from Astrazeneca outside the submitted work, and Michael Friedlander reports personal fees from MSD, Lilly, Takeda and Novartis outside the submitted work. Clare Scott has participated in non-remunerated advisory boards on mainstreaming and PARP inhibitor therapy for Astrazeneca, Clovis Oncology and Takeda.