Comparing Outcomes of Genetic Counseling Options in Breast and Ovarian Cancer: An Integrative Review
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ABSTRACT

PROBLEM IDENTIFICATION Genetic counseling is vital in helping people at high risk for hereditary breast and ovarian cancer (HBOC) make informed decisions to undergo BRCA testing. Many people, particularly those in rural locations, lack access to these services. This review examines evidence to determine if remotely delivered genetic counseling via telephone or telemedicine is an effective alternative to in-person counseling for people who are at high risk for HBOC.
. LITERATURE SEARCH A literature review was completed by searching PubMed, SCOPUS, and CINAHL® databases.
. DATA EVALUATION 151 articles were identified from the search, and 7 were included in the review.
. SYNTHESIS: Patients' BRCA knowledge acquisition, cancer-specific distress, anxiety, depression, and satisfaction with mode of counseling delivery were equivalent between in-person and remotely delivered counseling groups. Genetic testing rates were significantly higher in participants receiving in-person counseling. Remotely delivered genetic counseling was more convenient and less expensive. Mixed outcomes existed regarding counselor-patient communication. 
. IMPLICATIONS FOR PRACTICE The demand for genetic counseling will grow as advances in cancer genomics reveal genes that may contribute to cancer predisposition. Innovative delivery models are necessary to ensure that all people have access to care.