"A Much Needed Specialist Service": Patient Perspectives on Hereditary Cancer Risk Psychology Service Delivery and...

To evaluate a pilot specialist clinical psychology service for patients who have hereditary risk of breast and ovarian cancer (HBOC).

Multi-method study reviewing 51 patients' demographic data, their engagement with the service and psychological assessment data (PHQ-9 and GAD-7). Additionally, a reflexive thematic analysis was conducted on 16 patients' responses to patient feedback forms.

This study reviewed patients referred to this service, their engagement with interventions, and outcomes of interventions. Proportions of attendees experiencing clinical levels of depression and anxiety at intake decreased across moderate and severe levels at discharge with large effect sizes for both (d = 1.38 and d = 1.87). Patient feedback indicated very high levels of satisfaction, with the specialist nature of the service and dedicated time highlighted as particular strengths.

Demographics reflect the national setting as well as clinical characteristics of this cohort with 49% not having an identified genetic variant. Anxiety and depression symptoms among referred patients indicate elevated clinical needs relative to previously reported means for HBOC patients. Important learnings to consider for service development include: embedded service provision; supporting connections with family and peers; flexibility; and creation of more access points to the service. To our knowledge, this is the first study evaluating a pilot psychology service dedicated to individuals with HBOC. The findings support the value of a dedicated psychological service for people with HBOC and have implications for the design and delivery of such a service.