Medical management adherence as an outcome of genetic counseling in a pediatric setting

Purpose: We sought to determine whether the inclusion of a genetic counselor in an initial pediatric genetics visit had an impact on patient adherence to management recommendations, as compared with initial visits in which only genetics physicians were involved. Methods: This chart review included 198 pediatric patients seen for their initial visit to the general genetics clinic at the Cincinnati Children's Hospital Medical Center in 2008. Ninety-eight patients were seen by one or more genetics physicians (the non-genetic counselor group), and 100 patients were seen by a geneticist and a genetic counselor (the genetic counselor group). Medical management recommendations and evidence of adherence to recommendations were abstracted from the medical record; adherence rates were compared between the genetic counselor and non-genetic counselor groups. Results: Adherence was significantly associated with the inclusion of a genetic counselor (P = 0.009). Although type of management recommendation had a large impact on adherence, involvement of a genetic counselor significantly improved adherence in all three management recommendation categories. Conclusion: Involvement of a genetic counselor during an initial pediatric genetics visit may be associated with increased patient adherence. Further research is needed to determine whether this association applies in other genetic counseling settings and whether enhanced adherence results in improved medical outcomes.