Have You Ever Googled a Patient or Been Friended by a Patient? Social Media Intersects the Practice of Genetic Counseling

Perspectives of Rare Disease Social Media Group Participants on Engaging With Genetic Counselors: Mixed Methods Study

BACKGROUND

Social media provides a potential avenue for genetic counselors to address gaps in access to reliable genetics information for rare disease communities. However, only limited research has examined patient and family attitudes toward engaging with genetic counselors through social media.

OBJECTIVE

Our study assessed the attitudes of members of rare disease social media groups toward engaging with genetic counselors through social media, characteristics associated with greater interest, and the benefits and potential pitfalls of various approaches to such engagement.

METHODS

We conducted a mixed methods survey of patients and family members recruited from a systematic sample of rare disease Facebook groups. Patient characteristics and their associations with interest in engagement with genetic counselors were evaluated using univariate and bivariate statistics. Responses to open-ended questions were analyzed using thematic content analysis.

RESULTS

In total, 1053 individuals from 103 rare disease groups participated. The median overall interest in engaging with genetic counselors on social media was moderately high at 7.0 (IQR 4.0-9.0, range 0-10). No past experience with a genetic counselor was associated with greater interest in engaging with one through social media (µ=6.5 vs 6.0, P=.04). Participants expressed greatest interest (median 9.0, IQR 5.0-10.0) in engagement models allowing direct communication with genetic counselors, which was corroborated by the majority (n=399, 61.3%) of individuals who responded to open-ended questions explicitly stating their interest in 1-on-1 interactions. When asked what forms of support they would request from genetic counselors through social media, participants desired individualized support and information about how to access services. However, participants also expressed concerns regarding privacy and confidentiality.

CONCLUSIONS

Patients and family members in rare disease social media groups appear interested in engaging with genetic counselors through social media, particularly for individualized support. This form of engagement on social media is not meant to replace the current structure and content of genetic counseling (GC) services, but genetic counselors could more actively use social media as a communication tool to address gaps in knowledge and awareness about genetics services and gaps in accessible patient information. Although encouraging, concerns regarding privacy and feasibility require further consideration, pointing to the need for professional guidelines in this area.

Changing the mindset for precision medicine: from incentivized biobanking models to genomic data

The emerging paradigm in contemporary healthcare, precision medicine, is widely seen as a revolutionary approach to both clinical treatment and overall health promotion. Precision models are making use of the most up-to-date technological advancements – such as genomics and ‘big data’ processing – in an effort to tailor healthcare to each individual. Yet the list of hurdles to successful implementation of precision medicine is no secret. Among the challenges, it was recently suggested in this journal that we must change the ‘mindset’ of patients, practitioners and the wider public (McGonigle, 2016). And while precision medicine indeed demands a significant shift, we must not understate the extent of the overhaul required. In particular, I argue, against McGonigle's suggestion, that the ethical challenges regarding participant contributions cannot be tackled by relying upon existing models of incentivized blood banking or organ donation. Instead, the success of precision medicine requires a wholescale change in mindset.