Towards A Unified Concept Of Individualized Medicine

Hoffmann, Wolfgang; Krafczyk-Korth, Janina; Völzke, Henry; Fendrich, Konstanze; Kroemer, Heyo K.

doi:10.2217/pme.11.6

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…Shared decision-making is then used to identify which goals the patient wishes to pursue:

Clearly, the concept of individualized medicine requires a holistic and integrative approach…The doctor's task will be to condense all of these aspects into straightforward therapeutic options which can be discussed with the patient. In a shared decision process, it will ultimately be the patient's choice as to what therapeutic goals will be primarily pursued33

…”

Section: Resultsmentioning

confidence: 99%

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Individualisation of drug treatments for patients with long-term conditions: a review of concepts

et al. 2014

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ObjectivesPatients and policy makers advocate that drug treatments should be individualised. However, the term is used in a variety of ways. We set out to identify the range of related terminology and concepts in the general field of individualisation, map out the relationships between these concepts and explore how patients’ perspectives are considered.DesignWe consulted members of an established patient and public involvement group about their experience of medicine taking for long-term conditions and their ideas about individualisation. We then conducted a scoping review of the literature to explore how terms surrounding individualisation of drug treatment are used and defined in the literature, and to explore the extent to which patients’ perspectives are represented, with a view to informing future recommendations as to how individualisation can be operationalised.MethodsWe identified relevant literature using a range of search strategies. Two researchers independently extracted definitions of terms using a template. Inductive and deductive methods were used to explore the data.ResultsDefinitions were categorised according to the following themes: medical management; pharmacogenetics, the patient's perspective; interactions between the healthcare provider and patient and management of long-term conditions.ConclusionsWithin the literature reviewed, the involvement of patients in the ongoing management of drug treatment was largely absent. We propose the use of a new term ‘mutually agreed tailoring’ (MAT). This describes the ongoing pharmacological management of conditions that incorporates patients’ specific needs, experiences and existing strategies for using their medications, and the professionals’ clinical judgement. This usually includes patients monitoring their symptoms and, with the support of the professional, making appropriate product, dose or timing adjustments as necessary. Our previous work suggests that many patients and doctors are successfully practising MAT, so we suggest that a formal description may facilitate wider utilisation of strategies that will improve patient outcomes.

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“…Shared decision-making is then used to identify which goals the patient wishes to pursue:

…”

Section: Resultsmentioning

confidence: 99%

“…In a shared decision process, it will ultimately be the patient's choice as to what therapeutic goals will be primarily pursued33…”

Section: Resultsmentioning

confidence: 99%

Individualisation of drug treatments for patients with long-term conditions: a review of concepts

et al. 2014

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“…Greater knowledge should also enhance the use of existing therapies, reducing reliance on new premium-priced therapies. Whether this happens remains to be seen, especially given that, despite many decades of scientific advances, only a few genotyping or phenotyping tests are currently being used routinely in clinical practice [4,5,10,11,13,16,21,36],[105,121,122]. This is because of increasing knowledge and awareness that a given patient’s genomic and phenotypic make-up is appreciably more complex than initially believed, as well as the influence of environmental factors [1,9-12,16,36,49,117,122].…”

Section: Reviewmentioning

confidence: 99%

Personalizing health care: feasibility and future implications

Godman

Finlayson²,

Cheema

et al. 2013

BMC Med

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Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

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“…Population biobanks will supply scientists with information about genomic and other constitutional background as well as hard data on premorbid exposure to environmental factors, which can be linked to subsequent disease occurrence. The detailed scientific examination of biological material from patients, in combination with clinical data, will be an essential prerequisite for the more targeted therapies we hope to see in the future, those which have become known as personalized medicine (23,24). Thus, available evidence indicates that biobanks will constitute the foundation of biomedical science in coming years, and there is reason to fear that the access to suitable biological material will be the limiting factor.…”

Section: Clinical Research Biobanking and Personalized Medicinementioning

confidence: 99%

The Regional Research Biobank of Central Norway – “One biobank, many collections”

Halgunset¹,

Mikkelsen²,

Skogseth³

2012

Nor J Epidemiol

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Towards A Unified Concept Of Individualized Medicine

Abstract: …even with the most sophisticated diagnostics tools and algorithm-based treatments, therapeutic success will be determined, to a large extent, by individual priorities and beliefs shaped in a biographic, social and cultural framework…"

Cited by 14 publications

References 6 publications

Individualisation of drug treatments for patients with long-term conditions: a review of concepts

Individualisation of drug treatments for patients with long-term conditions: a review of concepts

Personalizing health care: feasibility and future implications

The Regional Research Biobank of Central Norway – “One biobank, many collections”

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