Direct-to-patient disclosure of results of mismatch repair screening for Lynch syndrome via electronic personal health record: a feasibility study.

Abstract

PurposeThe adoption of universal mismatch repair (MMR) screening of colorectal (CRC) and endometrial cancers (EC) has the potential to improve detection of Lynch syndrome (LS) and health outcomes among cancer patients and family members. Electronic patient health records (ePHRs) represent an innovative, resource-efficient route to deliver results directly to patients that could be enhanced by multi-media interventions to improve critical downstream outcomes. The current study examines feasibility and acceptability of this approach.MethodsPatients hospitalized for resection of CRC or EC were recruited to receive their MMR result via institutional ePHR. Baseline and follow-up assessments were conducted.Results74% (49/66) of eligible patients consented, and 81% (29/36) participants who had a result posted to their ePHR completed follow-up, surpassing feasibility thresholds, with 14% (5/36) receiving an abnormal result. Ratings of the study approach surpassed the acceptability threshold–97% had a mean score of ≥4 on a 7-point scale–and were high regardless normal or abnormal result. Ineligibility was more common among non-White (p=0.009) and ≥65 (p=0.035) participants due to low Internet use/no access.ConclusionePHR-based result disclosure for MMR screening is feasible to study and acceptable to patients, but minority and elderly patients may experience greater barriers to participation.