Increasing Utilization of Cancer Genetic Counseling Services Using a Patient Navigator Model.

Author(s): Rahm AK, Sukhanova A, Ellis J, Mouchawar J

Affiliation(s): Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado, alanna.k.rahm@kp.org.

Publication date & source: 2007-02-03, J Genet Couns., [Epub ahead of print]

Publication type:

Rarely has utilization of genetic counseling for Hereditary Breast and Ovarian Cancer (HBOC) been studied separately from utilization of testing. At Kaiser Permanente Colorado, consistently only 30% of all members referred for HBOC attend genetic counseling. To increase the volume of genetic counseling appointments, a patient navigator approach was pilot tested in a randomized-controlled trial over 3 months. A total of 125 members were referred for HBOC genetic counseling (55 randomized to PN, 70 randomized to usual care). Utilization of referrals for Navigator-assisted members was 44%, compared to 31% in the usual care arm (p=0.16). The patient navigator significantly decreased time to appointment, with over 80% of Navigator-assisted members seen for genetic counseling less than three months from referral date, compared to 32% in usual care (p=0.002). patient navigator assistance shortens time from referral to appointment for HBOC genetic counseling, and may increase utilization of such services.