Personalized Medicine: A Shift from Patient-Physician Engagement to Patient-Centered Care

posts-15

In the last decade, scientific advances have made it possible to diagnose and treat a rapidly growing number of diseases, especially various types of cancer with greater precision than ever before. These advancements have expanded the knowledge of researchers in customizing therapy with greater efficacy and reduced side effects. Personalized medicine (PM) provides a far more tailored treatment with the best response and highest safety margin to ensure better patient care. Personalized medicine holds promise in the improvement of healthcare by enabling each patient to receive earlier diagnoses, risk assessments, and optimal treatments and lower the costs. PM, by using pathophysiology-based information, guides clinicians to diagnose and treat the disease. The approach depends on an in-depth understanding of how a person’s unique molecular and genetic profile makes them susceptible to certain diseases.

What is Personalized Medicine?

Precision or personalized medicine is a novel approach for disease treatment that combines variability in genes, environment, and lifestyle for each person. It transforms medical interventions by providing effective, tailored therapeutic strategies based on the genomic, epigenomic and proteomic profile of an individual. PM may be considered an extension of traditional approaches to understanding and treating disease but with greater precision. The genetic profile of a patient can guide doctors to select drugs or treatment protocols that will improve health outcomes while minimizing harmful side effects. Physicians can now go beyond the one-size-fits-all model of prescribing to make more effective clinical decisions for each patient.

PM aims to provide the right drug with the right dose at the right time to the right patient. Clinicians can select a therapy or treatment protocol based on a patient’s molecular profile such as genomics, proteomics, transcriptomics that may not only minimize harmful side effects but also ensure a more successful outcome and will be a cost-effective approach as well. With genetic knowledge, doctors select the proper medication or therapy. The emergence of PM speeds up earlier disease detection via an enhanced use of existing biomarkers and detection of early genomic and epigenomic events in disease development. Also, PM has the potential to reduce healthcare costs while improving patient care.

Personalized Medicine: How Does It Differ from Traditional Medicine?

Traditional medicine follows the "one-size-fits-all" approach in which a prescribed drug is given to all but not everyone responds to treatment in the same way. Few drugs cause side effects and few do not work at all. Finding the right drug that works for the patient can involve a lot of trial and error. Precision medicine takes things a step further. By gaining knowledge about the patient's genetics, lifestyle, environment, clinicians prescribe the medicine that will be the best fit for the patient. Precision or personalized medicine is much more target specific. With the help of advanced biomedical tools, genetic and molecular testing and big data analytics, PM helps clinicians predict which medication and therapy will work best for the patient. It also reduces adverse effects, shifts the goal of medicine from reaction to prevention, improves cost-effectiveness. The goal of personalized medicine is to replace the current one-size-fits-all model in which an average therapy and medication are prescribed to all the patients with the same disease. PM tailors care to each patient's unique biology, lifestyle including their race, finance and living environment. There are many different gene variations that are involved in the metabolism of a whole plethora of drugs. Therefore, the identification of specific gene variant allows the prescription of drugs at effective levels while minimizing harmful side effects.

The Challenges to Overcome

PM is considered to be a revolutionary approach to patient care and the revolution by personalized medicine will require a great effort by researchers, clinicians, industries and most of all, patients. Despite its proven clinical effectiveness, in the current healthcare system, stakeholders and consumers do not yet completely believe the benefits of PM. There are few issues associated with the development of PM that needs to be resolved. Scientists should be more aware of the genetic markers that are the most clinically significant and convey the knowledge of integrating PM into medicine to treat specific diseases. Economic challenges are a major concern as there is a lack of knowledge of identifying technology and operational systems that will save costs. PM also raises ethical and social issues. The protection of the private information of patients during the investigation and development stages is important. Also, there are policy challenges regarding the association between government research and regulatory agencies. The future challenges, if resolved, will not only improve the efficacy of PM but also make people aware of its utility and clinical effectiveness.

The Promising Future of Personalized Medicine

PM has the potential to fulfill the requirement to improve health outcomes by reducing healthcare costs, drug-development costs and time. This can only be achieved by equal contribution of patient and consumers in participating in clinical trials, entrepreneurs and innovators to develop innovative tools to analyse the genetic information, physicians to investigate the disease at the molecular level, researchers to explore further research to uncover new insights at the molecular basis of disease in order to get a clear idea of target-based drug development, IT sector by creating electronic tools to collect and secure patient information. Scientists envisage that in the future, with the use of the personalized approach, each individual will receive their complete genomic information on the day of their birth. This information will help physicians and clinicians to implement more effective healthcare approaches based on patient exposure to different diseases.

The continuing enthusiasm for the concept of ‘personalized medicine’ is a testament to the power and range of opportunities offered by the use of molecular science and technological innovation in combination with traditional medical practice. Ultimately the success of this new phase of ‘personalized medicine’ will depend on the nature and level of benefits it can provide, both to individuals and to society more generally. In the coming years, molecular science and technological innovation will offer increasing opportunities to establish a new phase in healthcare practice. Personalized medicine will continue to be used as an umbrella term to cover the ever-increasing range of modern tools and information as well as the evolving practice of healthcare providers and demands of healthcare users.