Nurse Discusses How to Improve Compliance for Genetic Screening

Simple referrals may not be the best way to ensure that patients with cancer and their family undergo the genetic testing that they may need, according to recent research conducted at Saint Frances Medical Center.

Study author Michele Settelmyer, APN, MSN, WHNP-BC, recently sat down with Oncology Nursing News to discuss her findings, why the point-of-care model worked better, and the role that the oncology nurse can play in the world of cancer genetics — especially in the community setting where genetic counselors may not be available.

Oncology Nursing News: Could you give an overview of your study on implementing high-risk cancer screening, especially regarding genetic screening.

Settelmyer: I discussed implementing a high-risk assessment program in a community setting. For us, it was in a breast center in a large hospital. We discussed 2 different implementation models: the referral model and the point-of-care model. With the referral model, we did not see the numbers that we had hoped for patient compliance, so our second step was to implement the point-of-care model and we showed that we did have a greater increase in compliance for patients for the recommendations and follow-up that they needed to do.

In our case presentation, we showed that the referral model was difficult to get patient compliance. The point-of-care model and using software programs can make that much easier for the patients and the providers to collect that information, process it, do the risk assessment models, and determine if that patient and their family are at a hereditary cancer risk.

Can you explain how the point of care model works?

When we implemented the point-of-care process, we used CancerIQ software to collect the information from the patient, determine if they are at risk, and if they're at high risk, offer them a counseling appointment to determine if they were interested in genetic testing and then make their recommended follow-up or care based on their genetic tests and their risk assessment.

How can this research be used by oncology nurses?

Oncology nurses can use this information to actually do more. Oftentimes, it's in communities where genetic counselors are scarce. So, oncology nurses really can be that person, and they already are that person who is doing interviews with patients, getting their family history. [Nurses] are counseling them, they are educating them. Oncology nurses could be that role as the genetic specialist to determine if their patients are at high-risk for hereditary cancer. If they or their family are at high-risk for a genetic cancer, nurses can recommend genetic testing.

Oncology nurses can help their patients just by educating themselves and their patients on hereditary cancers and what that means for their families, such as who else needs to be tested, and how can these other family members get testing and take preventive actions so that they don't get cancer or that it at least is caught in its earliest possible stages when it is most treatable.

What role do oncology nurses play in genetic counseling in the community setting?

Oncology nurses can help in the community setting because genetic counselors are often not available, so the oncology nurse can be that resource for their patients. They can explain genetic testing and offer that testing to their patient to help them and their families determine if they are at that high risk for hereditary cancers.