A survey of genetic and palliative care health professionals' views of integrating genetics into palliative care

Genetic counselling and testing have utility for people with palliative care needs and their families. However, genetic and palliative care health professionals have described difficulties initiating palliative-genetic discussions. Between March and July 2022, we received n = 73 surveys (6% response rate) from genetic and palliative care health professionals in Australia and New Zealand that assessed and compared barriers and facilitators. The main perceived barrier to both groups was palliative care health professionals' lack of genetic knowledge (44%). Most palliative care health professionals were 'not at all confident' performing several activities, including discussing DNA banking (52%) and knowing their legal responsibilities when sharing genetic information (58%). The most frequently selected facilitator for genetic health professionals was fostering close relationships with palliative care health professionals (52%), while palliative care health professionals indicated a genetic referral template (51%) would be of assistance. Almost all participants agreed genetic discussions do not undermine the central ethos of palliative care (87%). Fewer palliative care health professionals considered themselves well situated to have genetic discussions with a palliative patient's family compared to genetic health professionals (p = 0.014). Our results suggest that genetic and palliative care health professionals support integrating genetics into palliative care, although refinement of the palliative care health professionals' role in this process is required. We have identified intervention targets to overcome barriers related to knowledge and confidence, which ought to be integrated into future interventions designed to support health professionals deliver the benefits of genetic information to people with palliative care needs and their families.

Automated summary

Genetic counselling and testing are valuable for individuals in palliative care and their families, but there are difficulties in initiating discussions on palliative-genetic topics according to genetic and palliative care health professionals. A survey was conducted between March and July 2022, with a response rate of 6%, involving professionals from Australia and New Zealand to assess and compare barriers and facilitators. The main perceived barrier for both groups was the lack of genetic knowledge among palliative care health professionals (44%). The study found that integrating genetics into palliative care is supported by both genetic and palliative care health professionals, but the role of palliative care health professionals in this process needs further refinement. Intervention targets have been identified to address barriers related to knowledge and confidence, which should be incorporated into future interventions aimed at supporting health professionals in providing genetic information to individuals in palliative care and their families.