Precision Medicine – the future of health.
“It is more important to know what sort of person has a disease, than to know what sort of disease a person has” – Hippocrates
The term ‘precision’ medicine refers to the assessment of patients’ health, based on risk of disease, or response to therapy, using specific diagnostic tests or techniques. This approach provides an opportunity for patients and healthcare providers to benefit from more targeted and effective treatments.
The stratification of patients into groups to guide treatment decisions is not a new concept; every time that we attempt to diagnose the underlying cause of a fever as either bacterial or viral, in the hope of prescribing the intervention most likely to tackle the cause, we are effectively practicing precision medicine.
However, in recent years, our understanding of both patients and their underlying conditions has significantly increased. Advances in our molecular vision of the origins of disease, coupled with the acceptance of a multi-modal approach to prevention and treatment, have had an exponential effect on health improvements, and should by now be affecting the way physicians interact with their patients. This new medicine, or precision medicine, has transformed our ability to identify those who will best respond to certain treatments, and offer best advice as to how to prevent disease in the first instance for those who are seeking the information. The reality of Precision or ‘P4’ Medicine, has entered a new phase.
Personalized medicine is one of the fasting growing fields in medicine today. Many forward-looking physicians are already using tools of the future that are currently available to offer patients a guide to achieving their best-health. Patients are now actively seeking practitioners who are skilled in listening to their needs and assessing their WHOLE HISTORY, and not just the presenting complaint.
Prediction is already being done regarding neurodegeneration, metabolic disorders, cardiac diseases, cancers & more. With advances in genome sequencing and the ability to map an individual’s genetic sequence, molecular characterisation of patients is now possible, with client specific advice and treatments now possible way in advance of development of disease.
Prevention is therefore the key to future health, and a road map of what individualised preventative strategies and treatments each patient should adopt is certainty now possible. Newer forms of adaptive treatments like the use of bio-identical hormones will form a key part of health maintenance in the future.
Participation is a necessity for successful result. But participation is 2-fold, and involves the patient adherence to advice and treatment, as well as the physicians ability to approach matters holistically. The rise of the expert patient has accompanied the rapid rate of technological change, and has led to a situation whereby medical professionals and the public often gain access to information and medical research advances simultaneously. As a result, patients can have a great depth of understanding about their condition and potential treatments. The traditionally paternalistic relationship between patient and clinician – in which the patient only has access to information provided by the clinician – is rapidly evolving and fast becoming outdated. And what a welcome change for patients and physicians alike. Whilst some view this as a threat, this may in fact provide the perfect storm for driving new forms of treatments, as doctors are realising that listening to patients forms a key part of their diagnosis and treatment plan.