Literature DB >> 9192264

The uptake and acceptability to patients of cystic fibrosis carrier testing offered in pregnancy by the GP.

N E Hartley1, D Scotcher, H Harris, P Williamson, A Wallace, D Craufurd, R Harris.   

Abstract

OBJECTIVE: To determine the uptake and acceptability of cystic fibrosis (CF) carrier testing when offered to women at the first antenatal booking appointment by their general practitioner.
SETTING: Eight-general practices in the north west region with a combined patient list size of 42000.
DESIGN: Offer of carrier screening at first antenatal booking appointment to pregnant women below 14 weeks' gestation; women accepting were alternately allocated to either couple testing (with full disclosure) or stepwise testing:
SUBJECTS: Six hundred and twenty three women were offered CF carrier testing. MAIN OUTCOME MEASURES: (1) Acceptance of the offer of CF carrier testing. (2) Acceptability of the test to women following screening, evaluated through (i) postal questionnaire, (ii) semistructured interview.
RESULTS: Five hundred and twenty-nine (84.9%) women accepted the test; the level of uptake varied across the eight practices (range 11-99%). In 26/249 (10%) couple tests no paternal sample was provided. When asked what had influenced their decision to be tested, 59/377 (16%) women did not refer to CF in their answers and six (2%) said that they did not feel they could refuse the test. After receiving their results, 368/379 (97%) women felt that they had made the right decision to be tested, but two carriers and three non-carriers had felt unhappy about testing. Couple testing with full disclosure was associated with lower anxiety levels two weeks after receiving the result for the pregnancy than stepwise testing and 82/278 (29%) non-carriers believed that they had no residual risk in relation to CF.
CONCLUSIONS: The response from women accepting CF carrier testing was largely positive but a minority of women expressed concern about the test and the way it was offered and a substantial proportion of women were falsely reassured by their "negative" result. Higher levels of acceptance tended to occur in the practices which offered the test there and then rather than giving couples more time to decide about testing. Some women appeared to have accepted the test because of a belief in the importance of testing in pregnancy rather than because of the disease in question.

Entities:  

Keywords:  Empirical Approach; Genetics and Reproduction

Mesh:

Year:  1997        PMID: 9192264      PMCID: PMC1050967          DOI: 10.1136/jmg.34.6.459

Source DB:  PubMed          Journal:  J Med Genet        ISSN: 0022-2593            Impact factor:   6.318


  13 in total

1.  Couple screening for cystic fibrosis.

Authors:  N J Wald
Journal:  Lancet       Date:  1991-11-23       Impact factor: 79.321

2.  Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening.

Authors:  Z H Miedzybrodzka; M H Hall; J Mollison; A Templeton; I T Russell; J C Dean; K F Kelly; T M Marteau; N E Haites
Journal:  BMJ       Date:  1995-02-11

3.  Uptake of cystic fibrosis testing in primary care: supply push or demand pull?

Authors:  H Bekker; M Modell; G Denniss; A Silver; C Mathew; M Bobrow; T Marteau
Journal:  BMJ       Date:  1993-06-12

4.  Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA.

Authors:  J R Riordan; J M Rommens; B Kerem; N Alon; R Rozmahel; Z Grzelczak; J Zielenski; S Lok; N Plavsic; J L Chou
Journal:  Science       Date:  1989-09-08       Impact factor: 47.728

5.  Cystic fibrosis carrier testing in early pregnancy by general practitioners.

Authors:  H Harris; D Scotcher; N Hartley; A Wallace; D Craufurd; R Harris
Journal:  BMJ       Date:  1993-06-12

6.  The psychological effects of false-positive results in prenatal screening for fetal abnormality: a prospective study.

Authors:  T M Marteau; R Cook; J Kidd; S Michie; M Johnston; J Slack; R W Shaw
Journal:  Prenat Diagn       Date:  1992-03       Impact factor: 3.050

7.  Identification of the cystic fibrosis gene: chromosome walking and jumping.

Authors:  J M Rommens; M C Iannuzzi; B Kerem; M L Drumm; G Melmer; M Dean; R Rozmahel; J L Cole; D Kennedy; N Hidaka
Journal:  Science       Date:  1989-09-08       Impact factor: 47.728

8.  Prenatal screening for cystic fibrosis: psychological effects on carriers and their partners.

Authors:  M E Mennie; M E Compton; A Gilfillan; W A Liston; I Pullen; D A Whyte; D J Brock
Journal:  J Med Genet       Date:  1993-07       Impact factor: 6.318

9.  Screening for carriers of cystic fibrosis through primary health care services.

Authors:  E K Watson; E Mayall; J Chapple; M Dalziel; K Harrington; C Williams; R Williamson
Journal:  BMJ       Date:  1991-08-31

10.  Decision making during the prenatal diagnostic procedure. A questionnaire and interview study of 211 women participating in prenatal diagnosis.

Authors:  B Sjögren; N Uddenberg
Journal:  Prenat Diagn       Date:  1988-05       Impact factor: 3.050

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  8 in total

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Authors:  Sylvia A Metcalfe
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Review 2.  Can we make assumptions about the psychosocial impact of living as a carrier, based on studies assessing the effects of carrier testing?

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Journal:  J Genet Couns       Date:  2010-09-29       Impact factor: 2.537

3.  Correlates of genetic counseling and testing among Orthodox Jews.

Authors:  Shulamis Juni Pollak
Journal:  J Relig Health       Date:  2009-08-11

4.  Attitudes of health care professionals toward carrier screening for cystic fibrosis. A review of the literature.

Authors:  S Janssens; A De Paepe; P Borry
Journal:  J Community Genet       Date:  2012-12-29

5.  Update and Review: Cystic Fibrosis.

Authors:  T Brown; E L Schwind
Journal:  J Genet Couns       Date:  1999-06       Impact factor: 2.537

6.  Cystic fibrosis prenatal screening in genetic counseling practice: recommendations of the National Society of Genetic Counselors.

Authors:  Elinor Langfelder-Schwind; Edward Kloza; Elaine Sugarman; Barbara Pettersen; Trisha Brown; Kim Jensen; Seth Marcus; Joy Redman
Journal:  J Genet Couns       Date:  2005-02       Impact factor: 2.537

7.  Antenatal screening for haemoglobinopathies in primary care: a whole system participatory action research project.

Authors:  Paul Thomas; Lola Oni; Mabel Alli; Judith St Hilaire; Alma Smith; Conan Leavey; Ricky Banarsee
Journal:  Br J Gen Pract       Date:  2005-06       Impact factor: 5.386

8.  Effectiveness of earlier antenatal screening for sickle cell disease and thalassaemia in primary care: cluster randomised trial.

Authors:  Elizabeth Dormandy; Martin Gulliford; Stirling Bryan; Tracy E Roberts; Michael Calnan; Karl Atkin; Jonathan Karnon; Jane Logan; Fred Kavalier; Hilary J Harris; Tracey A Johnston; Elizabeth N Anionwu; Vicki Tsianakas; Patricia Jones; Theresa M Marteau
Journal:  BMJ       Date:  2010-10-05
  8 in total

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