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Longitudinal follow-up after telephone disclosure in the randomized COGENT study.

ABSTRACT: PURPOSE:To better understand the longitudinal risks and benefits of telephone disclosure of genetic test results in the era of multigene panel testing. METHODS:Adults who were proceeding with germline cancer genetic testing were randomized to telephone disclosure (TD) with a genetic counselor or in-person disclosure (IPD) (i.e., usual care) of test results. All participants who received TD were recommended to return to meet with a physician to discuss medical management recommendations. RESULTS:Four hundred seventy-three participants were randomized to TD and 497 to IPD. There were no differences between arms for any cognitive, affective, or behavioral outcomes at 6 and 12 months. Only 50% of participants in the TD arm returned for the medical follow-up appointment. Returning was associated with site (p?

SUBMITTER: Kilbride MK

PROVIDER: S-EPMC7396300 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Longitudinal follow-up after telephone disclosure in the randomized COGENT study.

Kilbride Madison K MK Egleston Brian L BL Hall Michael J MJ Patrick-Miller Linda J LJ Daly Mary B MB Ganschow Pamela P Grana Generosa G Olopade Olufunmilayo I OI Fetzer Dominique D Brandt Amanda A Chambers Rachelle R Clark Dana F DF Forman Andrea A Gaber Rikki R Gulden Cassandra C Horte Janice J Long Jessica M JM Lucas Terra T Madaan Shreshtha S Mattie Kristin K McKenna Danielle D Montgomery Susan S Nielsen Sarah S Powers Jacquelyn J Rainey Kim K Rybak Christina C Savage Michelle M Seelaus Christina C Stoll Jessica J Stopfer Jill E JE Yao Xinxin Shirley XS Domchek Susan M SM Bradbury Angela R AR

Genetics in medicine : official journal of the American College of Medical Genetics 20200507 8

<h4>Purpose</h4>To better understand the longitudinal risks and benefits of telephone disclosure of genetic test results in the era of multigene panel testing.<h4>Methods</h4>Adults who were proceeding with germline cancer genetic testing were randomized to telephone disclosure (TD) with a genetic counselor or in-person disclosure (IPD) (i.e., usual care) of test results. All participants who received TD were recommended to return to meet with a physician to discuss medical management recommenda ...[more]

PMID: 32376981

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Project description:Background/objectivesTelephone follow-up calls could optimize the transition from the emergency department (ED) to home for older patients. However, the effects on hospital return rates are not clear. We investigated whether telephone follow-up reduces unplanned hospitalizations and/or unplanned ED return visits within 30 days of ED discharge.DesignPragmatic randomized controlled trial with allocation by month; odd months intervention group, even months control group.SettingTwo ED locations of a non-academic teaching hospital in The Netherlands.ParticipantsCommunity-dwelling adults aged ≥70 years, discharged home from the ED were randomized to the intervention group (N = 4732) or control group (N = 5104).InterventionIntervention group patients: semi-scripted telephone call from an ED nurse within 24 h after discharge to identify post-discharge problems and review discharge instructions. Control group patients: scripted satisfaction survey telephone call.MeasurementsPrimary outcome: total number of unplanned hospitalizations and/or ED return visits within 30 days of ED discharge.Secondary outcomesseparate numbers of unplanned hospitalizations and ED return visits. Subgroup analysis by age, sex, living condition, and degree of crowding in the ED at discharge.ResultsOverall, 42% were males, and median age was 78 years. In the intervention group, 1516 of 4732 patients (32%) consented, and in the control group 1659 of 5104 (33%) patients. Unplanned 30-day hospitalization and/or ED return visit was found in 16% of intervention group patients and 14% of control group patients (odds ratio 1.16; 95% confidence interval: 0.96-1.42). Also, no statistically significant differences were found in secondary outcome measures. Within the subgroups, the intervention did not have beneficial effects for the intervention group.ConclusionTelephone follow-up after ED discharge in older patients did not result in reduction of unplanned hospital admissions and/or ED return visits within 30 days. These results raise the question of whether other outcomes could be improved by post-discharge ED telephone follow-up.

Project description:BACKGROUND:Due to shorter hospitalization, patients have to take responsibility for their rehabilitation period at a very early stage. The objective of this trial is to study the effects of two treatment schemes following total knee arthroplasty: conventional treatment following discharge from hospital and early follow-up by telephone consultations in addition to conventional treatment following discharge from hospital. The ultimate aim is to increase the effectiveness of the treatment by improving patients' health status, promote self-efficacy, and reduce the number of acute visits to the orthopaedic outpatient clinic during the rehabilitation period. METHOD/DESIGN:The design is a randomized un-blinded parallel group clinical trial conducted at the Department of Orthopaedic Surgery, Gentofte Hospital, the Capital Region of Denmark. In total, 116 patients will be allocated by an external randomization program to 2 groups: an intervention group following usual treatment after discharge supplemented by a nurse managed structured follow-up consultation conducted by telephone 4 and 14 days after discharge from hospital and a control group following treatment as usual. The consultations are structured by key subjects relevant to assess the health status according to the VIPS-model (the Swedish acronym for the concepts Well-being, Integrity, Prevention and Safety). The content of the consultations can vary according to the patients´ individual situations and needs. All consultations are conducted by the researcher responsible for the trial. The effect is measured 1, 3, 6 and 12 months post-surgery. The primary outcome is self-reported physical function measured by The Western Ontario and McMaster Universities Arthritis Index. Secondary outcomes are self-reported health-related quality of life, general self-efficacy and the number of acute visits to the orthopaedic outpatient clinic. DISCUSSION:The result of this trial is expected to provide new knowledge to support the development of targeted and effective follow-up after total knee arthroplasty in order to improve the patients´ health-related knowledge and skills of being able to take actively part in their illness and improve their health status. TRIAL REGISTRATION:ClinicalTrials.gov: NCT01771315.

Dataset Information

Longitudinal follow-up after telephone disclosure in the randomized COGENT study.

Publications

Longitudinal follow-up after telephone disclosure in the randomized COGENT study.

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