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Medline ® Abstract for Reference 27

of 'Genetic counseling: Family history interpretation and risk assessment'

27
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Assessing controversial direct-to-consumer advertising for hereditary breast cancer testing: reactions from women and their physicians in a managed care organization.
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Mouchawar J, Laurion S, Ritzwoller DP, Ellis J, Kulchak-Rahm A, Hensley-Alford S
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Am J Manag Care. 2005;11(10):601.
 
OBJECTIVE: To describe the impact on patients and physicians at a managed care organization (MCO) of a direct-to-consumer advertising (DTC-ad) campaign concerning testing for the BRCA1 and BRCA2 genes.
STUDY DESIGN: Observational study.
METHODS: In 2003, we mailed a 30-item questionnaire to 750 randomly chosen female members of Kaiser Permanente Colorado (KPCO) aged 25 to 54 years, and 100 female KPCO members with a history of breast cancer genetic referral. We mailed a 7-item questionnaire to 180 randomly chosen KPCO primary care providers.
RESULTS: Of 394 patient respondents, 245 (62%) reported exposure to the DTC-ad of whom 63% reported that the DTC-ad caused no anxiety at all. A high level of perceived breast cancer risk and being of Hispanic ethnicity each were independently associated with reported anxiety due to the DTC-ad (adjusted odds ratio [OR]= 3.23, 95% confidence interval [CI]= 1.35, 7.73, and adjusted OR = 4.19, 95% CI = 1.48, 11.83, respectively). Greater knowledge was seen among respondents exposed to the DTC-ad than among those reporting no exposure (P = .015). Of the physician respondents, 84% reported that the DTC-ad caused no strain on the doctor-patient relationship, and nearly 80% reported no effect on daily clinical practice. Genetic referrals soared more than 200% compared with the prior year, when there was no advertising.
CONCLUSION: The DTC-ad had a marked impact on genetic services, but little apparent negative impact on patients or primary care providers at an MCO.
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Clinical Research Unit, Kaiser Permanente Colorado, 580 Mohawk Drive, Boulder, CO 80303, USA. judy.mouchawar@kp.org
PMID