Literature DB >> 35230657

Increased family history documentation in internal medicine resident continuity clinic at a community hospital through resident-led structured genetic education program.

Jirat Chenbhanich1, Ivy Riano2, Shreya Madhavaram2, Cagney Cristancho2, Alekya Poloju2, Víctor Alejandro Zavala González2, Nont Kosaisawe3, Thomas Treadwell2.   

Abstract

We aim to assess residents' perspectives and clinical utility of obtaining family history (FH) as well as to improve the rate of FH documentation in electronic medical record (EMR) at an internal medicine resident continuity clinic at a community hospital. The residents' perspectives were assessed with questionnaires. The study period was divided into the first 10-week Phase 1 in which genetic education interventions were delivered by residents, and the second 10-week Phase 2 with minimal intervention. FH documentation in EMR was reviewed and compared to a 4-week baseline (Phase 0). We found that time constraint was the most reported barrier. We reviewed 1197 patient visits; FH was recorded in 34% (67/200), 52% (272/522), and 50% (239/475) during Phase 0, Phase1, and Phase 2, respectively. Genetic education significantly increased the rate of FH documentation in Phase 1 from baseline, which was maintained in Phase 2 despite removal of interventions. The mean age of patients with documented FH was younger than those without documentation (48 years vs 51 years; p < 0.001). Documented FH of cancers and coronary artery disease lacked important details, such as age at diagnosis, in 62% (86/138) and 51% (41/81) of them, respectively. Out of 511 patients that had documented FH, we identified 66 patients (13%) where positive family history could alter medical management. In conclusion, resident-led structured genetic education effectively increased family history documentation in EMR in internal medicine resident continuity clinic and showed clinical utility.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Entities:  

Keywords:  Electronic health record; Family history; Internal medicine residency; Medical genetics; Pedigree; Qualitative study; Quality improvement

Year:  2022        PMID: 35230657      PMCID: PMC9270516          DOI: 10.1007/s12687-022-00581-4

Source DB:  PubMed          Journal:  J Community Genet        ISSN: 1868-310X


  21 in total

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Review 5.  2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

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Journal:  Circulation       Date:  2019-03-17       Impact factor: 29.690

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Authors:  Janet L Williams; Dave S Collingridge; Marc S Williams
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Journal:  Genet Med       Date:  2000 May-Jun       Impact factor: 8.822

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Authors:  S J Hayflick; M P Eiff; L Carpenter; J Steinberger
Journal:  Genet Med       Date:  1998 Nov-Dec       Impact factor: 8.822

Review 9.  Systematic review of the application of the plan-do-study-act method to improve quality in healthcare.

Authors:  Michael J Taylor; Chris McNicholas; Chris Nicolay; Ara Darzi; Derek Bell; Julie E Reed
Journal:  BMJ Qual Saf       Date:  2013-09-11       Impact factor: 7.035

10.  Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

Authors:  Paula Dhiman; Joe Kai; Laura Horsfall; Kate Walters; Nadeem Qureshi
Journal:  PLoS One       Date:  2014-01-09       Impact factor: 3.240

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