GP's role

 

  1. Where possible, take a three generational family history on both sides of the family, noting where appropriate:
  2. Age
  3. Age at diagnosis
  4. Age and cause of death
  5. Ancestry and cultural background
  6. Birth defects
  7. Step-relationships and adoption
  8. Stillbirths
  9. Miscarriages
  10. Terminations of pregnancy
  11. Children born of parents who are related
  12. This may be collected at the first visit, when a particular issue arises, or to provide information for preventive strategies. The patient should understand the reason for collecting this information, as some of it may be private, and may not be known by other members of the family.
  13. Ideally construct a pedigree, in either paper-based or electronic format where possible.
  14. Update patient’s pedigree including births, deaths and new diagnoses opportunistically.
  15. Be aware of, and able to discuss, possible risks of conditions that may be identified from the family history.
  16. Be aware of, and able to discuss, the ethical, legal and social issues arising when a genetic condition is identified in a family, including insurance implications.
  17. Consider the sensitivity of the language that you use in discussing genetic issues with families,
    eg different ways of explaining risk, mutation, and ethnicity.
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