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Integration of Germline Genetic Testing Into Routine Clinical Practice for Patients With Pancreatic Adenocarcinoma.

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Point of care germline genetic testing (GT) for pancreatic ductal adenocarcinoma (PDAC) patients achieved an 85% success rate. This integrated model using EHR tools and nudges proved feasible and acceptable to clinicians.

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Area of Science:

  • Oncology
  • Genetics
  • Health Services Research

Background:

  • Germline genetic testing (GT) is crucial for pancreatic ductal adenocarcinoma (PDAC) patients.
  • Traditional clinical genetics infrastructure faces limitations in meeting the needs of PDAC patients.

Purpose of the Study:

  • To describe the integration of point of care (POC) GT into routine clinical practice for all PDAC patients.
  • To evaluate the effectiveness and clinician acceptance of a novel POC GT model.

Main Methods:

  • Developed a clinical POC GT workflow integrating electronic health record (EHR) tools and behavioral nudges.
  • Compared GT rates between research and clinical POC cohorts.
  • Assessed clinician perceptions of the clinical POC model via surveys.

Main Results:

  • The clinical POC cohort achieved an 85.1% GT rate, compared to 76.7% in the research cohort.
  • Unlike the research cohort, no significant demographic differences were observed between patients who did and did not undergo GT in the clinical POC cohort.
  • Oncology clinicians rated the clinical POC model as acceptable (4.4/5), appropriate (4.6/5), and feasible (4.0/5).

Conclusions:

  • A clinical POC GT model utilizing EHR tools and behavioral nudges is effective for PDAC patients.
  • This model demonstrates high acceptability, appropriateness, and feasibility among oncology clinicians.
  • The integrated POC approach significantly improves GT rates in PDAC patients.