Healthcare providers attitudes towards risk stratification of adopted patients with limited family history information: a cross-sectional survey

J Community Genet. 2021 Jul;12(3):485-488. doi: 10.1007/s12687-021-00527-2. Epub 2021 Apr 20.


Familial medical history (FMH) is crucial for patient risk stratification; however, adopted patients' FMH knowledge may be limited. This can be problematic when determining steps in screening and management of patients. Little is known about providers' opinions and practices regarding adopted patients with limited FMH. This study explored healthcare providers' attitudes towards these patients and explored whether they interact differently with these individuals. We assessed providers' opinions regarding earlier screening, more aggressive management techniques, and genetic testing for this population. Surveys were mailed to 300 Family Practice Medical Doctors (M.D.s) and Doctors of Osteopathic Medicine (D.O.s), in the state of Ohio. Descriptive statistics were calculated, and chi-squared or Fisher's exact tests assessed relationships between provider characteristics and screening and management practices (alpha = 0.05). There was no association between years of practice or provider sex and how they screened, managed, or interacted with adopted patients. Providers that had adopted patients did not hold any statistically different opinions on how adopted patients should be managed versus providers that did not. Most providers did not initiate earlier screening for patients with unknown FMH, with the exception of D.O.s initiating earlier mammographic screening. However, all providers took more extensive personal histories and carried out more extensive monitoring. Although family medical history is only a piece of the puzzle when determining what medical care is right for a particular patient, it still remains an important aspect that needs to be addressed. Providers need to ensure that they are correctly managing patients with unknown familial risk factors.

Keywords: Adoption; Family history; Risk stratification.