Henry Ford Health System Henry Ford Health System Scholarly Commons
Obstetrics, Gynecology and Women's Health Women's Health Meeting Abstracts Services
2018
Referral patterns for genetic counseling for hereditary breast and ovarian cancer syndromes
Leah Hong Henry Ford Health System, [email protected]
Jacquelyn Roberson Henry Ford Health System, [email protected]
Roopina Sangha Henry Ford Health System, [email protected]
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Recommended Citation Hong L, Roberson J, and Sangha R. Referral patterns for genetic counseling for hereditary breast and ovarian cancer syndromes. Obstet Gynecol 2018; 131:52S.
This Conference Proceeding is brought to you for free and open access by the Obstetrics, Gynecology and Women's Health Services at Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Women's Health Meeting Abstracts by an authorized administrator of Henry Ford Health System Scholarly Commons. . In California, women qualify- nsurance get yearlong supplies of d, designating that women could dispensaries. A 2011 study found OBSTETRICS & GYNECOLOGY The authors did not report any potential conflicts of The authors did not report any potential conflicts of Short interval pregnancies are associated with an Access to birth control is the cornerstone to Women were satisfied with all approaches to post- Implementation of new laws take time and require This is a retrospective cohort study of clinic patients who 19,693 pharmacies met our inclusion criteria: commer- We are currently collecting date. Based on preliminary University of Connecticut Health Center, Farmington, CT UCLA Department of Obstetrics and Gynecology, Los Angeles, CA a friend. Although nonehalf of of the all materials participants highlighted chose LARCCONCLUSION: a methods, LARC method. partum contraception counseling in thisseven study, which minutes. on average Our tookhelpful. only Further PtDA research is needed offer to determine aFinancial its impact Disclosure: low-tech in the long-term. solutioninterest. that women find increased incidence of pretermgestational birth, age infants. low LARC birth deviceseffective weight, have been and in shown small tointerval, for be helping however safe and those women studiesimmediate did postpartum achieve not time evaluate period. an LARCMETHODS: placed optimal in the inter-pregnancy delivered at HartfordLARC. Hospital LARC and devices requested wereRyan immediate supplied program. postpartum by periodic Near shipmentsinsufficient the from end devices the of tointervention shipment meet in periods, demand. which theredevice This some were immediately patients led often received postpartum tomethod their and a and requested others asked pseudo-random LARC were to follow-up given for a outpatient temporary LARC placement. The secret shopper methods, we willCalifornia conduct pharmacies a cross-sectional to survey inquirewith of whether SB-999. they are ableMETHODS: to comply cial retail pharmacies in California.cancelled 13,660 licenses were or excluded because for they revoked/ publicly were affiliated funded with managed networks. care80%, Based or on 600 our pharmacies6033. pilot were Using study, a randomly for secretand a selected asked shopper whether power from technique, they of can thesebirth the dispense control pharmacies yearlong remaining to are supplies customers. of called prescription RESULTS: review of 200 pharmaciescalls, called, 44% with approximately ofobstacles 80% pharmacists to completed dispensing have yearlonginsurance supplies not of coverage heard birth (37%) control and of quoted companyCONCLUSION: were SB-999. policy (16%). The topinstitutional two accountability. Inlong revealing supplies obstacles of to birthSB-999. control, accessing we year- aim toFinancial expedite Disclosure: implementation of interest. Immediate Postpartum LARC PlacementDecrease May the Risk ofStephanie Short-Interval Higgins, MD Pregnancy [3E] Christopher Morosky, MD, and AmyINTRODUCTION: Nelson, MD California State Law (SB-999)Dispensing and a Implementation: Year-long SupplyControl of [2E] Prescription Birth Gelareh Nikpour, MD Antoinette Allen, BA, Sallyand Rafie, Angela PharmD, Chen, BCPS, MD, Radhika MPH Rible,INTRODUCTION: MD, preventing unplanned pregnancies ing for state-funded reproductive i contraception from participating a 30% oddsreceived yearlong reduction supplies of inthree-month birth control unplanned supplies as (Foster, pregnancies comparedifornia 2011). to when Senate one- Subsequently, Bill-999 or women inreceive was 2016, yearlong passe supplies Cal- ofrequiring birth insurance control companies from to pharmacists while fund these prescriptions.Using , ” 85% – ), were ” by American College of Obstetricians decision- ovarian “ ª “ , ” and Copyright Unauthorized reproduction of this article is prohibited. ” and Gynecologists. Published by Wolters Kluwer Health, Inc. breast “ 46% risk of developing – s decision and their values ’ decision quality Patients at high risk for heredi- “ decision-making process quality “ were not statistically different. Regardless of ” The authors did not report any potential conflicts of Effective postpartum contraceptive counseling BRCA 1 or 2 mutation carriers have a 45 . Women with a known cancer diagnosis were ” ) and the extent to which she is clear about her ” On postpartum day 1, women who had not received A retrospective electronic chart review was conducted to adnexa 126 patients were enrolled. The average age of partic- A total of 184 women with an average age of 46 years was “ ,or FRIDAY POSTERS ” 0.0152). The primary outcomes of decision quality 5 Albert Einstein College ofNew Medicine/Montefiore York Medical City, Center, NY Henry Ford Health System, Detroit, MI ovary “ p making process quality the material, women found them helpful and would recommend to ipants was 28.9, half wereprimiparous, Latina, and 69% 60% had had public a insurance,differences vaginal 42% among delivery. were the There were groupsPtDA, no except 6.6 statistical for min counseling for time the (6.4 website, and min 4.9 for min for the standard brochure, ( values and feelsevaluated informed using ( validated surveys. RESULTS: Financial Disclosure: interest. CONCLUSION/IMPLICATIONS: tary cancer syndromes shouldcounseling be based provided on with extensiveincluding a review the referral of ages family for of history genetic onset on of both cancer. sides, women were offered147/164 genetic testing, (89.6%) of apositive which hereditary total breast 147 and accepted. of ovarianwomen cancer Of were 14/147 mutation. noted the 10/147 to (9.5%) (6.8%) have a women variant mutation. identified with 13 (7.1%) from surgery,who and were 11 not (6%)insurance. self-referrals. The offered reasons Of genetic documented the forto testing, 20 lack inability of women to 5 genetic meet testing (25%) Medicare was criteria due had or lack federal of clinical assisted indication. 164 testing, insurance type and referringRESULTS: provider specialty. included. 93 (50.5%)44 referrals (23.9%) were from from internal obstetricians/gynecologists, medicine, 23 (12.5%) from family medicine, “ excluded. Information onincluding age, if race, testing if was genetic offered testing was and/or collected accepted, results of genetic 52S featured contraceptive options for side-by-side comparison,contraception 2) brochure, standard or 3)tive website options. with All comparisontool. patients of The received contracep- concordance counseling between utilizing a their patient assigned (PtDA) can facilitate counseling butfor the a optimal PtDA structure is and unknown. medium METHODS: a postplacental LARC were randomized to: 1) a paper-based PtDA that Erika Levi, MD, MPH,Miriam Molly Tarrash, Findley, BS, DO, and MPH, Nerys MS,INTRODUCTION: Benfield, Wendy MD, Leung, MPH MD, helps patients meet their reproductive life goals. Patient decision aids Contraceptive Counseling [1E] Sandolsam Cha, MD 4:30 PM–5:30 PM CONTRACEPTION/FAMILY PLANNING Effectiveness of a Patient Decision Aid in Postpartum 01/16 to 12/31/16 with a diagnosis that contained ovarian cancer by age 70. METHODS: identify women who wereGenetics referred department to for counseling, the as Henry new Ford consultations Health between 01/ System Jacquelyn Roberson, and Roopina Sangha,INTRODUCTION: MD risk of developing breast cancer and a 39 Hereditary Breast and Ovarian[40D] Cancer Syndromes Leah Hong, MD PRIMARY CARE Referral Patterns for Genetic Counseling for
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