IMPACT OF PATIENT NAVIGATION IN ONCOGENETICS WITHIN BRAZIL'S LARGEST PRIVATE HOSPITAL NETWORK.

Significance & Background: Patients seen in oncogenetics require longitudinal follow-up to enable early diagnosis and tailored prevention. However, high- risk individuals often fail to return after genetic testing or discontinue follow-up, compromising clinical management and continuity of care. Whi...

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Published in:Oncology Nursing Forum Vol. 53; no. 2; p. 283
Main Authors: Santos, Jennifer, Deus, Matheus, Marques, Fernanda
Format: Journal Article
Published: Oncology Nursing Society Mar2026
Online Access:View this record in EBSCOhost
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      dt: Mar2026
      vid: 53
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      pub: Oncology Nursing Society
      place: Pittsburgh, Pennsylvania
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        atl: IMPACT OF PATIENT NAVIGATION IN ONCOGENETICS WITHIN BRAZIL'S LARGEST PRIVATE HOSPITAL NETWORK.
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          Santos, Jennifer
          Deus, Matheus
          Marques, Fernanda
        affil: PhD, Oncology D'Or, São Paulo, São Paulos
      sug:
      ab: Significance & Background: Patients seen in oncogenetics require longitudinal follow-up to enable early diagnosis and tailored prevention. However, high- risk individuals often fail to return after genetic testing or discontinue follow-up, compromising clinical management and continuity of care. While patient navigation is well established in oncology, it remains underexplored in oncogenetics and represents a strategic opportunity to overcome barriers to access and adherence. Purpose: To assess the impact of patient navigation on return rates, time to follow-up appointments, and continuity of care among high-risk patients, including follow-up for reclassification of variants of uncertain significance (VUS). Interventions: We conducted two institutional pilot initiatives with retrospective chart reviews. Pilot 1: From January to December 2024, patients seen by a single oncogenetics specialist were followed by a nurse navigator from the initial consultation to the return visit. Indicators included return rate, mean interval to follow-up, and a performance coefficient (integrating rate, time, and volume). Results were compared against 13 physicians without navigation using Z-tests for proportions and Student's t-tests (alpha = 0.05). Pilot 2: In July 2025, thirteen patients with VUS and no scheduled follow-up were contacted via phone messages over the course of one week. As baseline, we reviewed 400 return/follow-up visits from the highest-volume oncogenetics specialist in 2024; after excluding 19 inconsistent records, 381 valid cases remained. Results: In Pilot 1, 1.548 patients were analyzed; 464 (29.9%) had both an initial and a return visit documented, enabling indicator calculation. The institutional average was 33.2% return rate with a mean 66.8-day interval. Among navigated patients (n=129), return rate was 66.7% (p=0.001), mean interval 49.8 days (p=0.003), and performance coefficient reached the 95th per- centile. In Pilot 2, within two days, we observed a 53.8% response rate, 38.5% intention to return, and 7.7% conversion to consultation, compared with 5.2% spontaneous follow-up in the baseline year. Discussion: Patient navigation in oncogenetics proved to be a high-impact, systematic, and replicable intervention, doubling return rates, reducing mean follow-up time by 25%, and strengthening adherence to prevention protocols. Pilot 2 further shows that even brief, proactive interventions can accelerate follow-up, sup-porting a scalable care management model. Initially applied to VUS carriers, the process is now expanding to all patients with identified pathogenic variants. To our knowledge, this is the first Brazilian study to demonstrate the impact of navigation on oncogenetics care.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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