{"id":399,"date":"2015-06-15T10:07:08","date_gmt":"2015-06-15T10:07:08","guid":{"rendered":"http:\/\/www.primarycaregenetics.org\/?page_id=399"},"modified":"2016-07-04T08:17:52","modified_gmt":"2016-07-04T08:17:52","slug":"primary-care-genetics-curriculum","status":"publish","type":"page","link":"https:\/\/www.primarycaregenetics.org\/?page_id=399&lang=en","title":{"rendered":"Primary Care Genetics Curriculum"},"content":{"rendered":"\t
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G<\/strong>en-Equip Project: curriculum in genetics and genomics for primary care professionals in Europe.<\/strong><\/p>\n

Introduction<\/strong><\/p>\n

This curriculum has been prepared as part of the Gen-Equip project to provide genetics education for primary care professionals. The topics were developed by the project team. First, a systematic review of the relevant literature was conducted to ascertain educational needs of primary care professionals. The curriculum was then developed at a workshop attended by experts in primary care, health education and clinical genetics.<\/p>\n

The project team see this curriculum as a dynamic tool on which to base the educational programme, however with changes in both genetics and primary care, it should be scrutinised regularly and amended as required to meet the needs of primary care practitioners. We therefore welcome comments or suggestions, which should be directed to Heather Skirton (heather.skirton@plymouth.ac.uk<\/a>).<\/p>\n

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1. Core topics<\/strong><\/td>\n<\/tr>\n
Topics<\/strong><\/td>\nDetails<\/strong><\/td>\n<\/tr>\n
Why is genetics relevant to primary care professionals?<\/strong><\/td>\nWhy genetics and genomics is relevant to primary care.
\nTypes of cases with a genetic or genomic component that are commonly seen inprimary care.<\/td>\n<\/tr>\n
Family history<\/strong><\/td>\nDefinition of first and second degree relativesReasons for collecting family history Important aspects of family medical history Interpretation of family medical historyAccurate recording and updating of family medical history<\/p>\n

Drawing a family tree<\/p>\n

Example questions for obtaining correct information.<\/td>\n<\/tr>\n

\u2018Red flags\u2019 when taking the family history<\/strong><\/td>\nIndications that the condition in the family could have agenetic cause, e.g. younger age of onset than usual, cases of bilateral disease.<\/td>\n<\/tr>\n
What genetic services do<\/strong><\/td>\nFamily and medical history taking, examination, assessment of risk, diagnosisTypes of testing used, including diagnostic, presymptomatic testing, carrier testing and prenatal diagnosis.<\/td>\n<\/tr>\n
Indications for referral to genetic services<\/strong><\/td>\nUse of national guidelines for referral to genetic services.<\/td>\n<\/tr>\n
How to refer to genetic services<\/strong><\/td>\nUse of national information on genetic services.<\/td>\n<\/tr>\n
Talking to patients about results<\/strong><\/td>\nPossible types of genetic test results; positive, negative, variants of unknown significanceInformation that should be included when discussing results.<\/td>\n<\/tr>\n
Ethical and social issues in primary care genetics<\/strong><\/td>\nConfidentialityDisclosure of information to relatives\/health professionalsConsanguinity<\/p>\n

Prenatal testing<\/p>\n

Possible termination of pregnancy<\/p>\n

Impact of diagnosis or test results on mortgage or life insurance.<\/td>\n<\/tr>\n

Basic genetic information and inheritance patterns<\/strong><\/td>\nMutations in DNAChromosomal abnormalities \u2013 including aneuploidyMendelian patterns of inheritance<\/p>\n

Mitochondrial inheritance<\/p>\n

Multi-factorial conditions.<\/td>\n<\/tr>\n

2. Targeted topics<\/strong><\/td>\n<\/tr>\n
Prenatal genetic care<\/strong><\/td>\nFamily history and risks from genetic conditions in the motherRisks of genetic conditions to the fetus
\nUnderstanding and communicating risks
\nUse of folic acid in pregnancyPrescribed medication in pregnancy.<\/td>\n<\/tr>\n
Preconception care<\/strong><\/td>\nScreening programs for genetic conditionsReferral pathway for genetic assessment and\/or testingPrenatal genetic testing<\/p>\n

Methods of collecting samples,<\/p>\n

Family history taking and interpretation<\/p>\n

Role of ethnicity in assessing genetic risk<\/p>\n

Consanguinity<\/p>\n

Use of folic acid<\/p>\n

Lifestyle issues, including smoking and alcohol use<\/p>\n

Prescribed medication and their impact on the fetus.
\nNIPT\/invasive.
\nUse of pre-implantation genetic diagnosis
\nEthical issues in prenatal testing.
\nUse of pre-implantation genetic diagnosis
\nEthical issues in prenatal testing.<\/td>\n<\/tr>\n

Paediatric care<\/strong><\/td>\nDiagnosis of pediatrics conditionsUse of new technologies to find diagnosisRecurrence risks for further children.<\/td>\n<\/tr>\n
Adult Cancer<\/strong><\/td>\nConcept of cancer as always due to genetic changesbut inherited forms high riskPopulation risks<\/p>\n

Use of up-to-date family history<\/p>\n

More detailed information about:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Hereditary breast and ovarian cancer<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Familial colon cancer (including Lynch syndrome)<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Rare cancer syndromes<\/td>\n<\/tr>\n

\u00a0<\/strong><\/td>\nRed flags \u2013 suspicion checklist<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nAlgorithms to assess risk for referral decisionsReferral pathway to cancer family history clinics or genetic clinics in your countryWhy patient with a family history may not be referred for genetic testing<\/p>\n

Understanding and communicating risks<\/td>\n<\/tr>\n

\u00a0<\/strong><\/td>\nAlgorithms to assess risk for referral decisionsReferral pathway to cancer family history clinics or genetic clinics in your countryWhy patient with a family history may not be referred for genetic testing<\/p>\n

Understanding and communicating risks.<\/td>\n<\/tr>\n

\u00a0<\/strong><\/td>\nUse of personalized medicine to target treatment.<\/td>\n<\/tr>\n
Adult Cardiovascular<\/strong><\/td>\nInherited forms of common diseases, including arrhythmias, cardiomyopathy, familial hypercholesterolemia.Need to take family history (including after sudden cardiac death) and ensure it is up to date<\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nPopulation riskAlgorithms to assess risk for referral decisions
\nReferral pathway in your country Understanding and communicating risksUnderstanding test results including known mutation, no mutation, variants of unknown significance<\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nScreening and preventive optionsChanging knowledge and management \u2013 need for review of casePersonalized medicine to target treatment.<\/td>\n<\/tr>\n
Pharmacogenomics<\/strong><\/td>\nExplanation of pharmacogenomicsExamples of useful applications in primary care (e.g. testing for statin sensitivity, avoiding iron therapy for thalassemia carriers)Examples of applications in cancer treatment.<\/td>\n<\/tr>\n
Genomics<\/strong><\/td>\nPredictive value of tests, especially for common conditionsUse of whole exome sequencing and whole genome sequencingAs situation is rapidly changing, need to ensure evidence for use of test, e.g. for use of NIPT.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\t\t<\/div> \n\t<\/div> \n\t
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A<\/strong>u<\/strong>t<\/strong>hors<\/strong><\/p>\n

The authors of this document are the partners in the Gen-Equip project:<\/p>\n

Heather Skirton, Leigh Jackson, Peter Lunt, Elisa Houwink, Martina Cornel, Daniela Turchetti, Alastair Kent, Stuart Pritchard, Milena Paneque, Vigdis Stefansdottir, Vlacava Curtisova.<\/p>\n

The additional contribution of Nadeem Qureshi is acknowledged.<\/p>\n

This work reflects only the author\u2019s views and the European Commission and Ecorys UK are not responsible for any use that may be made of the information it contains.<\/em><\/strong><\/p>\n\n\t\t<\/div> \n\t<\/div> \n\t\t<\/div> \n\t<\/div> \n<\/div>\n","protected":false},"excerpt":{"rendered":"Gen-Equip Project: curriculum in genetics and genomics for primary care professionals in Europe. Introduction This curriculum has been prepared as part of the Gen-Equip project to provide genetics education for primary care professionals. The topics were developed by the project team. First, a systematic review of the relevant literature was conducted to ascertain educational needs of primary care professionals. The curriculum was then developed at a workshop attended by experts in primary care, health education and clinical genetics. The project [...]","protected":false},"author":3,"featured_media":0,"parent":152,"menu_order":33,"comment_status":"closed","ping_status":"closed","template":"template-fullwidth.php","meta":{"ngg_post_thumbnail":0},"_links":{"self":[{"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/pages\/399"}],"collection":[{"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=399"}],"version-history":[{"count":26,"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/pages\/399\/revisions"}],"predecessor-version":[{"id":431,"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/pages\/399\/revisions\/431"}],"up":[{"embeddable":true,"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=\/wp\/v2\/pages\/152"}],"wp:attachment":[{"href":"https:\/\/www.primarycaregenetics.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}