Rosie O'Shea1,2, Nicole M Rankin3, Maira Kentwell4,5, Margaret Gleeson6, Lucinda Salmon7, Katherine M Tucker8, Sarah Lewis3, Natalie Taylor3,9. 1. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. rosie.oshea@sydney.edu.au. 2. Discipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia. rosie.oshea@sydney.edu.au. 3. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. 4. Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia. 5. Department of Oncology, Royal Women's Hospital Parkville, Parkville, VIC, Australia. 6. Hunter Family Cancer Service, Newcastle, NSW, Australia. 7. Department of Clinical Genetics, Austin Health, Melbourne, VIC, Australia. 8. Hereditary Cancer Clinic, Prince of Wales Hospital, University of New South Wales, UNSW, Sydney, NSW, Australia. 9. Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.
Abstract
PURPOSE: This study sought to determine genetics and oncology specialists' views of integrating BRCA1 and BRCA2 testing in epithelial ovarian and breast cancer into routine practice. METHODS: Qualitative interviews were designed using the Consolidated Framework for Implementation Research. Questions included experiences or views of the BRCA testing processes, implementation needs of oncology health professionals, perceived challenges, and future ideas for interventions to integrate genetic testing into oncology. RESULTS: Twenty-two participants were interviewed from twelve health organizations and four themes were identified: (1) embracing the shift to mainstream genetic testing, with the majority of participants viewing BRCA testing as clinically useful and routine use important for maintaining a patient centered process; (2) the need for communication networks and role delineation to integrate routine genetic testing; (3) factors that influence sustaining routine genetic testing, including ongoing training, resources and funding, real-world adaptation, system complexity, and champions; and (4) variation in system interventions for integrating routine genetic testing align to organizational context. CONCLUSION: Findings illustrate the need for integrating genetic testing into routine oncology, and that adaptation of interventions and processes is essential to sustain a feasible model. An understanding of individual and organizational implementation factors will help to prepare for future integration of routine genetic testing in other cancers.
PURPOSE: This study sought to determine genetics and oncology specialists' views of integrating BRCA1 and BRCA2 testing in epithelial ovarian and breast cancer into routine practice. METHODS: Qualitative interviews were designed using the Consolidated Framework for Implementation Research. Questions included experiences or views of the BRCA testing processes, implementation needs of oncology health professionals, perceived challenges, and future ideas for interventions to integrate genetic testing into oncology. RESULTS: Twenty-two participants were interviewed from twelve health organizations and four themes were identified: (1) embracing the shift to mainstream genetic testing, with the majority of participants viewing BRCA testing as clinically useful and routine use important for maintaining a patient centered process; (2) the need for communication networks and role delineation to integrate routine genetic testing; (3) factors that influence sustaining routine genetic testing, including ongoing training, resources and funding, real-world adaptation, system complexity, and champions; and (4) variation in system interventions for integrating routine genetic testing align to organizational context. CONCLUSION: Findings illustrate the need for integrating genetic testing into routine oncology, and that adaptation of interventions and processes is essential to sustain a feasible model. An understanding of individual and organizational implementation factors will help to prepare for future integration of routine genetic testing in other cancers.
Entities:
Keywords:
interventions and implementation; mainstreaming; oncology; routine genetic testing
Authors: Jana K McHugh; Gozie Offiah; Sean Daly; Nazmy El Beltagi; Michael Kevin Barry; Seamus O'Reilly; Terri P McVeigh Journal: Ir J Med Sci Date: 2021-06-30 Impact factor: 2.089