Personalised medicine: are we ready?

Louis, Renaud; Roche, Nicolás

doi:10.1183/16000617.0088-2017

Cited by 7 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both types of personalisation were discussed in these results. The former taken too far can be criticised for abdication of responsibility to individuals [ 99 ], whilst the latter alone might be too solely biological and neglect human factors [ 100 ].…”

Section: Discussionmentioning

confidence: 99%

A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders

et al. 2022

View full text Add to dashboard Cite

Introduction People with schizophrenia spectrum disorder diagnoses commonly have poor sleep, which predicts various negative outcomes. The problems are diverse, including substantial circadian dysregulation, sleep-wake timing issues, hypersomnia (excessive sleep), and more classic insomnia. Methods This paper reports on a mixed methods expert opinion study based on the principles of Delphi methodology. The study examines and explores opinion on the optimal contents and format for an occupational therapy intervention to improve poor sleep in this population. Views of clinical and academic topic experts (n = 56), were elicited, examined and explored in three rounds, views from previous rounds being presented back to participants in subsequent rounds. Participants with relevant personal experience (n = 26) then rated and commented on suggestions, with a focus on acceptability. Descriptive statistics and graphs of ratings were triangulated with qualitative content analysis of free-text. Results Participants emphasised the central importance of intervention personalisation, although the manner and extent of personalisation suggested varied. Many components and domains were acknowledged as important, with the challenge being how to keep such an intervention simple, brief, and feasible for end-users, for sustainable implementation. The strongest consensus was to address evening routine, daytime activity, and environmental interventions. Relaxation, mindfulness, thermoregulation, sensory factors, and cognitive or psychological approaches were rated as less important. There was disagreement on whether to include time in bed restriction, and how to address napping, as well as how far to address medication timing. Clinicians and researchers advocated some version of stimulus control, but participants with personal experience reported low levels of acceptability for this, describing entirely negative experiences using ‘the 15-minute rule’ (part of stimulus control). Conclusion These results are informative for clinicians treating sleep problems in people with schizophrenia and related conditions, as well as for decision makers considering the potential contribution of the profession of occupational therapy toward sleep treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In parallel, there has been a proliferation of guidelines on COPD care, produced at various levels ranging from global (i.e., Global initiative on chronic Obstructive Lung Disease, GOLD) [1] to continental (e.g., from the European Respiratory Society, ERS or American Thoracic Society, ATS), national or even more local [7]. One crucial issue in the current treatment paradigms is personalisation, as part of 4P (personalised, predictive, preventive and participatory) or precision medicine [8, 9]. Accordingly, a lot of research is ongoing to identify endotypes, i.e., biological mechanisms that can be identified using biomarkers and targeted by specific treatments, and are associated with one or more clinical phenotypes with specific evolutionary profile and/or response to treatments [8].…”

Section: Introductionmentioning

confidence: 99%

Are there specific clinical characteristics associated with physician’s treatment choices in COPD?

Roche¹,

Antoniadis²,

Hess³

et al. 2019

Respir Res

Self Cite

View full text Add to dashboard Cite

Background The number of pharmacological agents and guidelines available for COPD has increased markedly but guidelines remain poorly followed. Understanding underlying clinical reasoning is challenging and could be informed by clinical characteristics associated with treatment prescriptions. Methods To determine whether COPD treatment choices by respiratory physicians correspond to specific patients’ features, this study was performed in 1171 patients who had complete treatment and clinical characterisation data. Multiple statistical models were applied to explain five treatment categories: A: no COPD treatment or short-acting bronchodilator(s) only; B: one long-acting bronchodilator (beta2 agonist, LABA or anticholinergic agent, LAMA); C: LABA+LAMA; D: a LABA or LAMA + inhaled corticosteroid (ICS); E: triple therapy (LABA+LAMA+ICS). Results Mean FEV1 was 60% predicted. Triple therapy was prescribed to 32.9% (treatment category E) of patients and 29.8% received a combination of two treatments (treatment categories C or D); ICS-containing regimen were present for 44% of patients altogether. Single or dual bronchodilation were less frequently used (treatment categories B and C: 19% each). While lung function was associated with all treatment decisions, exacerbation history, scores of clinical impact and gender were associated with the prescription of > 1 maintenance treatment. Statistical models could predict treatment decisions with a < 35% error rate. Conclusion In COPD, contrary to what has been previously reported in some studies, treatment choices by respiratory physicians appear rather rational since they can be largely explained by the patients’ characteristics proposed to guide them in most recommendations. Electronic supplementary material The online version of this article (10.1186/s12931-019-1156-1) contains supplementary material, which is available to authorized users.

show abstract

Médecine du sommeil personnalisée et syndrome d’apnées hypopnées obstructives du sommeil : entre précision et stratification, une proposition de clarification

Gauld¹,

Dumas²,

Darrason³

et al. 2020

Médecine du Sommeil

View full text Add to dashboard Cite

Personalised medicine: are we ready?

Cited by 7 publications

References 27 publications

A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders

A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders

Are there specific clinical characteristics associated with physician’s treatment choices in COPD?

Médecine du sommeil personnalisée et syndrome d’apnées hypopnées obstructives du sommeil : entre précision et stratification, une proposition de clarification

Contact Info

Product

Resources

About