Many pediatricians uncomfortable providing care to kids with genetic conditions

New study finds general physicians order few genetic tests, don't always discuss risks and benefits; take limited family histories

2013-11-19

(Press-News.org) Contact information: Mary Masson
mfmasson@umich.edu
734-764-2220
University of Michigan Health System
Many pediatricians uncomfortable providing care to kids with genetic conditions New study finds general physicians order few genetic tests, don't always discuss risks and benefits; take limited family histories Ann Arbor, Mich. — Many primary care pediatricians say they feel uncomfortable providing health care to patients with genetic disorders. Also, many do not consistently discuss all risks and benefits of genetic tests with patients, according to research published today in the American Journal of Medical Genetics.

Investigators from the University of Michigan's C.S. Mott Children's Hospital and The Children's Hospital at Montefiore (CHAM) conducted a national survey of 88 physicians who are part of the American Academy of Pediatrics Quality Improvement Innovation Networks, assessing their comfort level ordering genetic tests for their pediatric patients, their attitudes toward genetic medical care and their choices regarding taking family histories. The majority of those physicians reported ordering few genetic tests (three or less times) per year, excluding newborn screening which is federally mandated for all newborns; few (13 percent) strongly agreed that they discussed the potential risks, benefits, and limitations of genetic tests with all their patients and only half felt competent in providing healthcare to patients with genetic disorders.

"While genetics has historically been viewed as a discipline focused on rare conditions, recent genomic advances have highlighted that genetics has a role in common conditions encountered in primary care medicine," said Beth Tarini, M.D., M.S., F.A.A.P., senior author, assistant professor of pediatrics, Child Health Evaluation & Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan and co-medical director of the Genetics in Primary Care Institute (GPCI), a project of the American Academy of Pediatrics. "Unfortunately, most PCPs have received insufficient education and training about genetics, which has left them uncertain about their role in providing genetics related care."

The study found that 100% of study participants stated that taking a family history is important, but less than one-third stated that they gather a minimum of a three-generation family history, a basic component of a genetic medical evaluation. Previous studies have shown that using family history and genetic information greatly improved outcomes for patients so researchers encourage patients to know their family history and share this with their providers in order to optimize their health care. "PCPs play an integral role in caring for children with genetic conditions and it is vital that they feel comfortable identifying issues and providing comprehensive care to suit their patients' unique needs," said Michael L. Rinke, M.D., Ph.D., lead author and assistant medical director for quality, CHAM, and assistant professor of pediatrics at Albert Einstein College of Medicine of Yeshiva University. "Thousands of children in the U.S. are diagnosed with genetic disorders annually and in order to optimize outcomes for these patients' early identification and medical intervention is essential."

The researchers say that robust education, increased access to resources, improved electronic health records systems to document family histories and rigorous quality improvement efforts are key to enhancing integration of genetic medicine into routine primary preventative care.

Tarini says that the national Genetics in Primary Care Institute Quality Improvement Project hopes to identify effective strategies so that physicians who are at the forefront of diagnosing and managing patients with genetic disorders feel confident and competent in their abilities to provide care for these patients.

### This study is particularly timely as Thanksgiving approaches. In 2004, the Surgeon General declared Thanksgiving to be National Family History Day. All Americans are encouraged to talk about, and to write down, the health problems that seem to run in their family during this time of family togetherness. Knowing the family's health history may help ensure a longer, healthier future together. (http://www.hhs.gov/familyhistory/)

About the University of Michigan's C.S. Mott Children's Hospital: Since 1903, the University of Michigan has led the way in providing comprehensive, specialized health care for children. From leading-edge heart surgery that's performed in the womb to complete emergency care that's there when you need it, families from all over come to the U-M C.S. Mott Children's Hospital for our pediatric expertise. For more information, go to http://www.mottchildren.org

About Montefiore Medical Center As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and regionally by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. For more information please visit http://www.montefiore.org and http://www.montekids.org.

ELSE PRESS RELEASES FROM THIS DATE:

Natural compound mitigates effects of methamphetamine abuse, University of Missouri researchers find

2013-11-19

Natural compound mitigates effects of methamphetamine abuse, University of Missouri researchers find COLUMBIA, Mo. – Studies have shown that resveratrol, a natural compound found in colored vegetables, fruits and especially grapes, may minimize the ...

New models predict where E. coli strains will thrive

2013-11-19

New models predict where E. coli strains will thrive Bioengineers at the University of California, San Diego have used the genomic sequences of 55 E. coli strains to reconstruct the metabolic repertoire for each strain. Surprisingly, these reconstructions ...

UEA research reveals how farmers could mitigate nitrous oxide emissions

2013-11-19

UEA research reveals how farmers could mitigate nitrous oxide emissions Farmers may be able to help reduce emissions of the greenhouse gas nitrous oxide (N2O) by incorporating copper into crop fertilisation processes – according to new research from the University ...

Underwater 'tree rings'

2013-11-19

Underwater 'tree rings' Calcite crusts of arctic algae record 650 years of sea ice change Almost 650 years of annual change in sea-ice cover can been seen in the calcite crust growth layers of seafloor algae, says a new study from the University of Toronto Mississauga ...

Among patients with recent ACS, use of enzyme inhibitor does not reduce risk of cardiovascular event

2013-11-19

Among patients with recent ACS, use of enzyme inhibitor does not reduce risk of cardiovascular event Chicago – Stephen J. Nicholls, M.B.B.S., Ph.D., of the South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, ...

In enzyme's isoforms, hope for developing heart drugs that improve contractility, prevent SCD

2013-11-19

In enzyme's isoforms, hope for developing heart drugs that improve contractility, prevent SCD (SALT LAKE CITY)—Drugs known as PDE3 inhibitors save many lives by helping failing hearts do a better job of pumping blood. But those same medications come with ...

National study finds renal stenting does not improve outcomes for renal artery stenosis patients

2013-11-19

National study finds renal stenting does not improve outcomes for renal artery stenosis patients Rhode Island Hospital researchers play lead roles in study; will present findings at the annual meeting of the American Heart Association PROVIDENCE, R.I. – According to the findings ...

2 studies on the use of breast MRI

2013-11-19

2 studies on the use of breast MRI CHICAGO – The overall use of breast magnetic resonance imaging has increased, with the procedure most commonly used for diagnostic evaluations and screenings, according to a study published by JAMA Internal Medicine, a JAMA ...

Beta-blockers before surgery appear associated with lower risk of heart-related events

2013-11-19

Beta-blockers before surgery appear associated with lower risk of heart-related events Giving beta-blocker medication to patients with heart disease undergoing noncardiac surgery appears to be associated with a lower risk of death and major adverse cardiovascular events (MACE) ...

Poorer, rural counties have lower CPR training rates

2013-11-19

Poorer, rural counties have lower CPR training rates Cardiopulmonary resuscitation (CPR) training appears to be lower in more rural counties, those with higher proportions of black and Hispanic residents and lower household incomes, and in the South, Midwest ...