Risk Communication in Families of Children with Familial Hypercholesterolemia: Identifying Motivators and Barriers to Cascade Screening to Improve Diagnosis at a Single Medical Center
- 14 August 2018
- journal article
- research article
- Published by Wiley in Journal of Genetic Counseling
- Vol. 28 (1), 50-58
- https://doi.org/10.1007/s10897-018-0290-0
Abstract
Familial hypercholesterolemia (FH) is severely underdiagnosed in the USA; yet, factors influencing family notification about risk for FH in the US pediatric setting have not been well elucidated. Most previous research on these factors has occurred in adult patient populations in European countries with organized cascade screening programs; therefore, we sought to characterize parent experiences with cascade screening in the US pediatric setting. A quantitative survey measuring family notification of FH risk information was administered to 38 parents of children with FH identified within a pediatric cardiology clinic. Participants were also asked if family notification was impacted by intrapersonal, interpersonal, institutional, community, and public policy factors identified previously in other populations. Notification of at least one of the proband’s living grandparents or aunts/uncles was reported by 76% (n = 25/33) and 71% (n = 24/34) of participants, respectively. The most common reason for notification was to protect relatives from heart disease. Two of the most common reasons participants did not notify relatives were a lack of information about FH and concern that the relative would have difficulty understanding the information. Yet, only a minority of participants (39%) accessed institutional resources such as educational materials to share with relatives or assistance drafting a family letter that could address these barriers. Based on the identified barriers and motivators for family communication, we suggest facilitators to improve implementation of cascade screening.Funding Information
- University of Minnesota
This publication has 44 references indexed in Scilit:
- The roles of past behavior and health beliefs in predicting medication adherence to a statin regimenPatient Preference and Adherence, 2012
- Patients' experiences and views of cascade screening for familial hypercholesterolemia (FH): a qualitative studyJournal of Community Genetics, 2011
- Electronic Chart Review of A Multispecialty Internal Medicine Practice Evaluating Appropriate Identification of Patients with Familial Hyperlipidemia*Journal of Clinical Lipidology, 2011
- Defining the challenges of FH Screening for familial hypercholesterolemiaJournal of Clinical Lipidology, 2010
- Efficacy of statins in familial hypercholesterolaemia: a long term cohort studyBMJ, 2008
- Molecular screening for familial hypercholesterolaemia: consequences for life and disability insuranceEuropean Journal of Human Genetics, 2007
- Family communication regarding inherited high cholesterol: Why and how do patients disclose genetic risk?Social Science & Medicine (1982), 2007
- Letting the family know: balancing ethics and effectiveness when notifying relatives about genetic testing for a familial disorderJournal of Medical Genetics, 2006
- Cascade testing in familial hypercholesterolaemia: how should family members be contacted?European Journal of Human Genetics, 2005
- Coronary Artery Disease in 116 Kindred with Familial Type II HyperlipoproteinemiaJournal of the American College of Cardiology, 1974