Genetic Counseling Educational Videos Significantly Improve Access to Genetic Testing and Counseling for Inpatients with Cardiovascular Disease

BackgroundGenetic testing for inherited cardiovascular conditions is recommended by multiple national guidelines to inform medical management. However, access to genetic counseling and testing is often limited particularly in the inpatient setting. Cardiologists cite lack of access to genetic counselors as a reason for not pursuing genetic testing. Genetic test education videos have been successfully implemented in the outpatient setting to increase patient volumes and decrease wait times, but they have not been studied in the inpatient setting. MethodsThis was a pilot study utilizing a genetic test education video in lieu of a traditional genetics consult for inpatients with a suspected hereditary cardiomyopathy, arrhythmia or familial hypercholesterolemia. Patients completed the cardiovascular multidimensional model of informed choice (MMIC) and SURE scales to assess whether the video provided sufficient information to make an informed decision. ResultsOver 22 months, 186 adult cardiovascular inpatients at Johns Hopkins Hospital were referred with 112 patients consenting to the study. Implementation of the pre-test videos increased the average number of monthly consults from 1 to 8. After watching the video, 90% (100/111) of patients made an informed choice to proceed with genetic testing using the MMIC scale. Using the SURE scale, 87% (97/112) of patients had no decisional conflict regarding whether or not to proceed with genetic testing. ConclusionsThese results indicate a pre-test genetic educational video could be considered as a strategy to scale access to genetic counseling and cardiovascular genetic testing, especially in hospital systems where access to genetics is limited in the inpatient setting.