Evaluation of a virtual, nurse practitioner–led, pre-counselling seminar for mainstream germline genetic testing using a patient-reported outcomes measure (PROM).

Abstract

290 Background: Ovarian cancer (OC) is a common, often fatal disease where 1/4 of cases are due to hereditary syndromes. Genetic screening of OC patients provides access to targeted treatments and screening recommendations. Patients are currently referred to a virtual, group, pre-counseling seminar, delivered by a Nurse Practitioner, where consent for germline genetic testing is obtained and results are delivered later by a Genetic Counsellor (GC). Previously, we found group pre-counseling to be an effective method to decrease wait times from diagnosis to test results. The purpose of this study was to evaluate the patient seminar experience using the previously validated, Genetic Counselling Outcome Scale (GCOS-24). BC Cancer- Victoria is a satellite of BC Cancer, providing tertiary cancer care to a population of ̃1.2 million. Methods: We completed a REB approved, prospective study recruiting patients referred to the group pre-counseling consenting seminar. The GCOS-24 was delivered electronically both pre (1) and post (2) attendance at the seminar, and 4 weeks post genetic counselling visit (3). Inclusion criteria included OC patients referred for germline BRCA testing between Jan 1, 2021, to Feb 28, 2022, > 18 years old who attended the group consenting seminar. Patients who could not communicate in English were excluded. Data was stored electronically via REDCap, a secure web-based platform. Results: Thirty-eight patients attended the seminar and 28 consented to participate and completed the first questionnaire. Twenty-five patients completed the second questionnaire and 21 completed the third. The average age was 67, with 80% high grade serous, 11% low grade, 6% clear cell and 3% endometrioid OC subtypes. Forty- nine percent of participants were from Victoria area, and 11% were 225+ km away. The average GCOS-24 score for pre seminar participants was 111, post seminar 121 and post GC’s appointment 124. Twelve (52%) patients scored minimum clinically important difference (MCID) increase between questionnaires 1 and 2, and 14 (67%) patients scored MCID increase between questionnaires 1 and 3. The questions reflecting the most improvement in average scores between questionnaires 1 and 3 were exploring knowledge and emotions. Conclusions: Virtual group pre-counseling sessions for OC patients are feasible and allow germline genetic testing access to a geographically diverse group of eligible patients. Mean GCO-24 score almost reached MCID between pre seminar and post seminar visit and did reach MCID between pre counselling and post GC visit. There was a general trend to improved scores as patients moved from counselling naïve to pre-counseling to completed GC appointment. Virtual pre-counseling seminars should be considered as high impact, resource light method of improving access to germline genetic counselling for OC patients.