Table 3.
Factors Associated With Usually or Always Discussing All Six Counseling Items
| Characteristic | Unadjusted Proportion Discussing All Six Items (%) | P | Discussion of All Six Items*
|
P | |
|---|---|---|---|---|---|
| Adjusted Odds | 95% CI | ||||
| Sex | .10 | .73 | |||
| Male | 65.7 | Reference | |||
| Female | 72.1 | 1.08 | 0.72 to 1.61 | ||
| Specialty | < .001 | .06 | |||
| Medical oncologist | 73.5 | Reference | |||
| Surgeon | 64.0 | 0.54 | 0.31 to 0.93 | ||
| Geneticist | 78.7 | 0.41 | 0.18 to 0.96 | ||
| Gynecologist/obstetrician | 53.9 | 0.62 | 0.33 to 1.17 | ||
| Other/missing | 56.0 | 0.62 | 0.33 to 1.15 | ||
| No. of years since medical school graduation | .40 | — | |||
| ≤ 15 | 68.7 | — | |||
| 16-23 | 68.0 | — | |||
| 24-29 | 70.1 | — | |||
| ≥ 30 | 64.0 | — | |||
| Unknown | 82.1 | — | |||
| No. of BRCA1/2 tests sent during past year | < .001 | .20 | |||
| 1-3 | 57.9 | Reference | |||
| 4-15 | 64.7 | 0.85 | 0.51 to 1.40 | ||
| ≥ 16 | 80.9 | 1.36 | 0.75 to 2.5 | ||
| Counsels and tests patients who are referred by other physicians for possible BRCA1/2 testing | < .001 | .53 | |||
| Yes | 75.7 | Reference | |||
| No/missing | 55.8 | 0.86 | 0.53 to 1.38 | ||
| Schedules specific visits for counseling | < .001 | .09 | |||
| Always/usually | 76.8 | Reference | |||
| Never/sometimes | 55.9 | 0.69 | 0.45 to 1.06 | ||
| Total No. of minutes of counseling before BRCA1/2 testing | < .001 | < .01 | |||
| ≤ 30 | 55.0 | Reference | |||
| 31-60 | 75.2 | 1.48 | 0.91 to 2.42 | ||
| > 60 | 89.8 | 3.70 | 1.66 to 8.29 | ||
| Staff member(s) counseling | < .001 | .05 | |||
| Physician only | 58.5 | Reference | |||
| Physician assisted by genetic counselor/nurse geneticist/NP/PA | 82.5 | 2.0 | 1.19 to 3.37 | ||
| Physician assisted by other counselor | 64.3 | 1.37 | 0.86 to 2.18 | ||
| Unknown | 50.0 | 0.89 | 0.36 to 2.21 | ||
| Practice bills for professional time associated with counseling | < .001 | .39 | |||
| Yes | 74.3 | Reference | |||
| No/missing | 58.6 | 0.83 | 0.54 to 1.27 | ||
| US Census region | .78 | — | |||
| Northeast | 68.6 | — | |||
| Midwest | 69.5 | — | |||
| South | 65.6 | — | |||
| West | 70.3 | — | |||
Abbreviations: NP, nurse practitioner; PA, physician assistant.
*
Using logistic regression to control for all variables in the table except for number of years since medical school graduation and geographic region. Analyses excluded 14 physicians who did not respond to the section on counseling, five physicians missing information on no. of minutes counseling, and two physicians missing information on whether they schedule a specific visit for counseling. Wald CIs are given, and P values are based on the likelihood ratio χ2 test.