Compliance and satisfaction with BRCA surveillance in specialized clinics versus community follow-up
Rita Vortman1, Moran Echar2, Amihood Singer3
1Neonatal Intensive Care Unit, Rambam Health Care Campus.
Insights
BRCA1/2 carriers show better adherence and satisfaction with medical follow-up in dedicated clinics. Expanding these specialized centers and improving general healthcare support are crucial for optimal cancer surveillance.
Area of Science:
- Oncology
- Genetics
- Healthcare Management
Background:
- BRCA1/2 gene mutations significantly increase cancer risk, necessitating rigorous medical follow-up protocols.
- Adherence to surveillance and patient satisfaction are critical for effective management of high-risk individuals.
- Current healthcare settings may present challenges in providing specialized care for BRCA carriers.
Purpose of the Study:
- To evaluate adherence to medical follow-up protocols among individuals with BRCA1/2 mutations.
- To compare the effectiveness of dedicated BRCA carrier clinics versus community healthcare settings for surveillance.
- To assess patient satisfaction with follow-up care in different healthcare environments.
Main Methods:
- A cross-sectional study utilizing anonymous questionnaires distributed to members of the 'Good BRCA Genes - Support and Information Group for BRCA Carriers'.
- The questionnaire assessed adherence to recommended surveillance schedules and satisfaction levels with various aspects of care.
- Data were analyzed comparing outcomes for BRCA carriers managed in dedicated clinics versus community settings.
Main Results:
- Overall adherence to recommended medical follow-up was 68.5%, with common barriers including bureaucracy and scheduling issues.
- Satisfaction with appointment availability, scheduling, and healthcare professionals' knowledge was below 50% in general settings.
- BRCA carriers in dedicated breast clinics demonstrated significantly higher adherence (78.3% vs. 53.6%) and greater satisfaction across multiple care parameters (P < 0.0001).
Conclusions:
- Dedicated BRCA1/2 clinics offer superior monitoring and patient satisfaction compared to community healthcare settings.
- There is a pressing need for more specialized BRCA carrier clinics to meet growing demand.
- Alternative solutions like enhanced professional training, digital tools, and AI should be explored to improve surveillance.
Objective:
To assess adherence to medical follow-up protocols among BRCA1/2 carriers and compare outcomes between dedicated carrier clinics and community healthcare settings.
Methods:
This cross-sectional study was conducted by distributing an anonymous questionnaire within the 'Good BRCA Genes - Support and Information Group for BRCA Carriers' association. The questionnaire assessed adherence to recommended surveillance and satisfaction with various aspects of the follow-up.
Results:
Of the 682 BRCA carriers surveyed, 68.5% reported fully adhering to recommended medical follow-up. Those not fully adhering cited bureaucracy challenges, scheduling difficulties, timing uncertainties, and difficulty remembering examination dates. Less than 50% were satisfied with appointment availability, scheduling, contact persons, and general practitioners' knowledge of BRCA carrier risks and follow-up. The 417 women monitored in dedicated breast clinics reported notably higher optimal adherence to recommended surveillance (78.3 vs. 53.6%, P < 0.0001). In addition, they noted greater satisfaction with appointment availability (63.7 vs. 25.0%, P < 0.0001), appointment scheduling process (58.1 vs. 24.7%, P < 0.0001), availability of breast surgeons/gynecology specialists (67.4 vs. 50.8%, P < 0.0001), and availability of a contact person for consultations between appointments (53.5 vs. 20.8%, P < 0.0001).
Discussion:
Our findings highlight the advantages of surveillance in dedicated BRCA1/2 clinics, including closer monitoring and increased satisfaction. Given the limited availability of such clinics and the growing number of BRCA1/2 carriers, the opening of additional dedicated clinics and the consideration of alternative surveillance-enhancing solutions, such as training healthcare professionals, using digital tools, and employing artificial intelligence, are essential.
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