The uptake of family screening in hypertrophic cardiomyopathy and an online video intervention to facilitate family communication

Mol Genet Genomic Med. 2019 Nov;7(11):e940. doi: 10.1002/mgg3.940. Epub 2019 Sep 3.

Abstract

Background: Individuals with hypertrophic cardiomyopathy (HCM), even when asymptomatic, are at-risk for sudden cardiac death and stroke from arrhythmias, making it imperative to identify individuals affected by this familial disorder. Consensus guidelines recommend that first-degree relatives (FDRs) of a person with HCM undergo serial cardiovascular evaluations.

Methods: We determined the uptake of family screening in patients with HCM and developed an online video intervention to facilitate family communication and screening. Family screening and genetic testing data were collected through a prospective quality improvement initiative, a standardized clinical assessment and management plan (SCAMP), utilized in an established cardiovascular genetics clinic. Patients were prescribed an online video if screening of their FDRs was incomplete and a pilot study on video utilization and family communication was conducted.

Results: Two-hundred and sixteen probands with HCM were enrolled in SCAMP Phase I and 190 were enrolled in SCAMP Phase II. In both phases, probands reported that 51% of FDRs had been screened (382/749 in Phase I, 258/504 in Phase II). Twenty patients participated in a pilot study on video utilization and family communication. Nine participants reported watching the video and six participants reported sharing the video with relatives; however only one participant reported sharing the video with relatives who were not yet aware of the diagnosis of HCM in the family.

Conclusion: Despite care in a specialized cardiovascular genetics clinic, approximately one half of FDRs of patients with HCM remained unscreened. Online interventions and videos may serve as supplemental tools for patients communicating genetic risk information to relatives.

Keywords: cascade screening; family communication; genetic testing; hypertrophic cardiomyopathy; uptake.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiomyopathy, Hypertrophic / diagnosis*
  • Cardiomyopathy, Hypertrophic / genetics
  • Cardiomyopathy, Hypertrophic / psychology
  • Family
  • Female
  • Follow-Up Studies
  • Genetic Predisposition to Disease*
  • Genetic Testing / methods*
  • Genetic Testing / trends
  • Health Communication
  • Health Education / methods*
  • Health Promotion / methods
  • Humans
  • Male
  • Mass Screening / psychology*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Online Systems*
  • Patient Acceptance of Health Care
  • Patient Participation / psychology*
  • Patient Participation / statistics & numerical data
  • Pilot Projects
  • Prognosis
  • Prospective Studies