Genetics

What Do You Really Need to Know About Your Patient’s Family History?

CLINICAL ACTIONS:

Establish a mechanism in your practice to elicit, interpret and routinely update your patients’ Family Health History (FHH) to determine potential increased risks for hereditary conditions to your patient and offspring
- Consider eliciting new information during annual routine physicals visits
Gather information on health status of all biological first- and second-degree relatives. To the best of patient’s knowledge, elicit and record the following:
- Current age or age at death
- Gender at birth
- Medical conditions with ages of onset and any issues with intellectual disabilities
- Maternal and paternal ethnicity and note any consanguinity
Information on health status of third-degree relatives may be useful in some instances
Refer for genetic counseling to discuss complex, or highly suggestive FHH

SYNOPSIS:

A detailed and accurate family health history can serve as an important screening tool, to assist in determining whether your patient and/or their offspring may be at increased risk for certain hereditary or familial conditions. This information can be important in determining if increased medical surveillance for certain conditions may be warranted.

Any patient with a family history that is suggestive of a familial or hereditary condition should be referred for more detailed discussion in a genetic counseling setting.

KEY POINTS:

Patients may filter the information that they tell you, or may not know their family history. Try to determine their level of knowledge regarding their FHH, and ask them to gather more information that may impact their level of risk.

Ask specific, but open-ended questions
A completed family history form may be utilized to obtain and document FHH
- It is helpful to remind the patient why this information is being gathered and why it is important