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Genetics professionals are key to the integration of genetic testing within the practice of frontline clinicians

  • Maren T. Scheuner
    Correspondence
    Correspondence and requests for materials should be addressed to Maren T. Scheuner, San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121
    Affiliations
    Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA

    Department of Medicine, University of California San Francisco, San Francisco, CA

    Department of Pediatrics, University of California San Francisco, San Francisco, CA
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  • Paloma Sales
    Affiliations
    Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA
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  • Katherine Hoggatt
    Affiliations
    Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA

    Department of Medicine, University of California San Francisco, San Francisco, CA
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  • Ning Zhang
    Affiliations
    Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA
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  • Mary A. Whooley
    Affiliations
    Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA

    Department of Medicine, University of California San Francisco, San Francisco, CA
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  • Michael J. Kelley
    Affiliations
    National Oncology Program, Specialty Care Services, Department of Veterans Affairs, Washington, DC

    Durham VA Health Care System, Durham, NC

    Department of Medicine, Duke University, Durham, NC
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Published:October 27, 2022DOI:https://doi.org/10.1016/j.gim.2022.09.012

      Abstract

      Purpose

      Genetic tests have become widely available. We sought to understand the use of genetic tests in the practice of frontline clinicians within the United States Department of Veterans Affairs (VA).

      Methods

      We administered a web-based survey to clinicians at 20 VA facilities. Physicians, nurse practitioners, physician assistants, and pharmacists were eligible. We excluded genetics providers and clinicians not seeing patients. We used multiple logistic regression to evaluate the associations between clinician characteristics and experience with genetics.

      Results

      The response rate was 11.3% (1207/10,680) and of these, 909 respondents were eligible. Only 20.8% of the respondents reported feeling prepared to use genetic tests and 13.0% of the respondents were currently ordering genetic tests; although, it was usually only 1 or 2 a year. Delivery of genetic tests without involving genetics providers was preferred by only 7.9% of the respondents. Characteristics positively associated with currently ordering genetic tests included practice in clinical and research settings, believing improving genetics knowledge could alter their practice, feeling prepared to use genetic tests, and referral of at least 1 patient to genetics in the past year.

      Conclusion

      Most VA clinicians don’t feel prepared to use genetic tests. Those with genetic testing experience are more likely to consult genetics providers. The demand for genetics providers should increase as frontline clinicians use genetic tests in their practice.

      Keywords

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