Discussing genetic risk may have little impact on patient behavior
The communication of genetic information may depend on how much it is framed as a risk to health or used to inform recommendations for wellness, study authors noted.
The results of DNA tests have little or no impact on patients' behavior, such as stopping smoking or increasing physical activity, a study found.
British researchers reviewed the results of 18 studies that reported on 7 behavioral outcomes to determine the effects of communicating genetic risk estimates of heart disease, cancers, and Alzheimer's disease. They looked at behavior changes which could potentially reduce these risks, such as smoking cessation (6 studies; n=2,663), diet (7 studies; n=1,784), and physical activity (6 studies; n=1,704). Other outcomes analyzed were motivation to change behavior and levels of depression and anxiety. This study updated a previous Cochrane review from 2010, adding 11 studies to the 7 previously identified.
Results appeared March 15 in The BMJ.
Meta-analysis revealed no significant effects of communicating DNA-based risk estimates on smoking cessation (odds ratio, 0.92; 95% CI, 0.63 to 1.35, P=0.67), diet (standardized mean difference, 0.12; 95% CI, −0.00 to 0.24, P=0.05), or physical activity (standardized mean difference, −0.03; 95% CI −0.13 to 0.08, P=0.62). There were also no effects on any other behaviors, such as use of alcohol, medication, or sun protection; attendance at screening or behavioral support programs; or motivation to change behavior.
The researchers point out that the studies predominantly had high or unclear risk of bias, and evidence was typically of low quality. Researchers speculated that the communication of genetic information may depend on how much it is framed as a risk to health or used to inform recommendations for wellness.
“Given the continued high expectations for the communication of DNA based disease risk estimates to motivate risk-reducing behaviour change, it is important that any additional randomised controlled trials are conducted using methodologically robust designs,” the researchers wrote. “These would be powered to detect possible small effects on behaviour (that might have important population consequences), and conducted and reported cognisant of the risks of bias—for example, by incorporating prespecified outcomes, valid measures of behaviour, and the blinding of outcome assessors.”