Replace Genetic Counselors With Educational Videos?

New study shows that prostate cancer patients prefer video education over meeting with genetic counselors prior to precision medicine testing

Recent research published in Cancer Genetics has demonstrated that patients who are considering genetic testing for prostate cancer prefer pretest educational videos over genetic counseling. Hospital leaders looking for ways to address shortages in genetic counseling staff, and provide more economic precision medicine teaching solutions, will benefit from being aware of patients’ preferences.

Researchers from Thomas Jefferson University conducted a study that offered patients with prostate cancer two different options prior to undergoing genetic testing for their cancer. Patients were offered the opportunity to meet with a genetic counselor or watch an 11-minute pretest educational video, following which they could ask questions.

Use of Pretest Educational Videos in Genetic Testing

The pretest educational video provided a wide variety of precision medicine information, covering the purpose of the genetic testing and how it related to patients’ cancers. The video also included information about the risks and benefits of genetic testing, and the different results that could be expected. The information also covered the various genetic risks and implications that different results could indicate.

Study Points to Patient Preferences for Genetic Testing Counseling

Published as part of “Pretest Genetic Education Video Versus Genetic Counseling for Men Considering Prostate Cancer Germline Testing: A Patient-Choice Study to Address Urgent Practice Needs,” the study found that the men considering genetic testing highly preferred an educational video over speaking to a genetic counselor. Some 71% of the patients chose to use the video, while only 29% chose to speak with professional genetic counselors. Both groups chose to undergo genetic testing at about the same rate, although the rate for men who chose the video was slightly higher.

“This is the first study with real-world data to publish on a pretest video in a male population in the context of prostate cancer germline testing,” said lead investigator Veda N. Giri, MD, in a recent Renal and Urology News piece. “Results are supportive of practice change for alternate delivery of pretest information for men to make an informed decision for genetic testing.” Giri is a medical oncologist at the Sidney Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, Pennsylvania, and serves as the director of the center’s Cancer Risk Assessment and Clinical Cancer Genetics Program.

The majority of patients who chose to use the video over meeting with a genetic counselor provided several reasons for doing so, including:

greater convenience,
less time commitment, and
avoiding waiting time.

The study also found that the major motivator for patients who chose to meet with a genetic counselor was the ability to ask in-person questions.

While Pretest Genetic Test Video Was Preferred …

The most significant findings in the study were that, while video was preferred over genetic counseling, use of the video did not negatively impact patients’ understanding of the testing or make patients less likely to undergo the testing. “The sample size was robust enough to deliver meaningful results on key patient-reported outcomes, such as decisional conflict for genetic testing and satisfaction with the process,” Giri explained. “Importantly, there was no difference in uptake of genetic testing among men who chose pretest video versus genetic counseling.”

“Prostate cancer is now entering a new era,” Daniel P. Petrylak, MD, Professor of Medicine and Urology at Yale School of Medicine said in a recent OncLive article. “In lung and breast cancer, we use molecular markers to select treatment. Historically, we were using a one-size-fits-all approach for prostate cancer; however, we now have molecular biomarkers of the DNA repair.”

May Compensate for Shortage of Genetic Counselors

As precision medicine applications for diseases such as prostate cancer advance, the availability of genetic counselors who can discuss the implications of genetic testing is becoming a barrier to precision medicine testing. Alternatives to meeting with a genetic counselor allow hospitals additional flexibility in providing essential teaching to patients considering genetic tests.

Hospital administrators will ultimately benefit from this recent research. This study not only provides hospitals with a clearer understanding of how patients prefer to learn about genetic testing, but also provides them with an important precision medicine teaching option that can help them to avoid the costs and staffing shortages that occur when using genetic counselors.

By providing video-based precision medicine education, hospitals can have greater flexibility in providing genetic testing education while simultaneously providing patients with options that they have been shown to prefer.

—Caleb Williams