Personalized medicine in Europe: not yet personal enough?

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Personalized medicine has the potential to allow patients to receive drugs specific to their individual disease, and to increase the efficiency of the healthcare system. There is currently no comprehensive overview of personalized medicine, and this research aims to provide an overview of the concept and definition of personalized medicine in nine European countries.

Methods

A targeted literature review of selected health databases and grey literature was conducted to collate information regarding the definition, process, use, funding, impact and challenges associated with personalized medicine. In-depth qualitative interviews were carried out with experts with health technology assessment, clinical provisioning, payer, academic, economic and industry experience, and with patient organizations.

Results

We identified a wide range of definitions of personalized medicine, with most studies referring to the use of diagnostics and individual biological information such as genetics and biomarkers. Few studies mentioned patients’ needs, beliefs, behaviour, values, wishes, utilities, environment and circumstances, and there was little evidence in the literature for formal incorporation of patient preferences into the evaluation of new medicines. Most interviewees described approaches to stratification and segmentation of patients based on genetic markers or diagnostics, and few mentioned health-related quality of life.

Conclusions

The published literature on personalized medicine is predominantly focused on patient stratification according to individual biological information. Although these approaches are important, incorporation of environmental factors and patients’ preferences in decision making is also needed. In future, personalized medicine should move from treating diseases to managing patients, taking into account all individual factors.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2205-4) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 43

Record: found
Abstract: found
Article: not found

The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review.

Ann-Marie Rosland, Michele Heisler, John D. Piette (2012)

In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts); however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient's autonomous motivation.

0 comments Cited 63 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy.

Barbara L. Dunn, H Sandler, Hector Pimentel … (2005)

We sought to elucidate long-term changes in health-related quality-of-life (HRQOL) outcomes by prospectively re-evaluating a well-characterized cohort of prostate cancer (PC) survivors 4 to 8 years after primary treatment. Patients who had been evaluated previously at a median of 2.6 years after radical prostatectomy (RP), external radiation (three-dimensional conformal radiation therapy [3-D CRT]), or brachytherapy (BT) were recontacted at a median of 6.2 years after treatment. The clinical relevance of long-term HRQOL impairment among survivors was established by comparison with controls of similar age. Factors associated with HRQOL changes during this interval were evaluated. Of the 964 eligible men, 709 (73.5%) completed measurable questionnaires. In four domains (urinary irritative-obstructive, urinary incontinence, bowel, and sexual), significant HRQOL differences were detected for at least one of the therapy groups, compared with controls (all P < .05). During the 4-year interval, significant improvement was observed for the urinary irritative-obstructive (P < .0001) and bowel (P < .0001) domains among BT patients, whereas urinary incontinence HRQOL worsened for both the BT (P = .0017) and 3-D CRT (P = .0008) treatment groups. Overall sexual HRQOL deteriorated for the 3-D CRT cohort (P = .0017), as well as for controls (P = .0136). Among RP patients, significant HRQOL changes were not observed. During a 4-year interval from earlier to longer-term phases of PC treatment survivorship, sexual, urinary, and bowel dysfunction remain significant concerns among early-stage PC treatment survivors, compared with control men. Although postprostatectomy HRQOL remains relatively stable during this interval, disease-specific HRQOL continues to evolve among men treated with BT and 3-D CRT.

0 comments Cited 61 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Issues surrounding the health economic evaluation of genomic technologies.

James Buchanan, Sarah Wordsworth, Anna Schuh (2013)

Genomic interventions could enable improved disease stratification and individually tailored therapies. However, they have had a limited impact on clinical practice to date due to a lack of evidence, particularly economic evidence. This is partly because health economists are yet to reach consensus on whether existing methods are sufficient to evaluate genomic technologies. As different approaches may produce conflicting adoption decisions, clarification is urgently required. This article summarizes the methodological issues associated with conducting economic evaluations of genomic interventions.

0 comments Cited 49 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Antonello Di Paolo:

ORCID: http://orcid.org/0000-0002-2661-6183

+39-050-2218755 , antonello.dipaolo@med.unipi.it , antonello.dipaolo@gmail.com

François Sarkozy: francois.sarkozy@fsnb.eu

Bettina Ryll: bettina.ryll@gmail.com

Uwe Siebert: uwe.siebert@umit.at

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 19 April 2017

Publication date PMC-release: 19 April 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 289

Affiliations

[1 ]ISNI 0000 0004 1757 3729, GRID grid.5395.a, Department of Clinical and Experimental Medicine, Section of Pharmacology, , University of Pisa, ; Via Roma 55, 56126 Pisa, Italy

[2 ]FSNB Health & Care, Carenity, Paris, France

[3 ]ISNI 0000 0004 1936 9457, GRID grid.8993.b, Melanoma Patient Network Europe; Evolutionary Biology Centre, , Uppsala University, ; Uppsala, Sweden

[4 ]ISNI 0000 0000 9734 7019, GRID grid.41719.3a, Department of Public Health, Health Services Research and Health Technology Assessment, , UMIT – University for Health Sciences, Medical Informatics and Technology, ; Hall in Tyrol, Austria

[5 ]Area of Health Technology Assessment, ONCOTYROL – Center for Personalized Cancer Medicine, Innsbruck, Austria

Author information

Antonello Di Paolo http://orcid.org/0000-0002-2661-6183

Article

Publisher ID: 2205

DOI: 10.1186/s12913-017-2205-4

PMC ID: 5395930

PubMed ID: 28424057

SO-VID: f0fb6866-bb4d-418d-b8a4-8e6b7fa29963

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 14 October 2016

Date accepted : 30 March 2017

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100004336, Novartis;

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: personalized medicine,definition,patient stratification,patient preferences

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: personalized medicine, definition, patient stratification, patient preferences

Personalized medicine in Europe: not yet personal enough?

Read this article at

Abstract

Background

Methods

Results

Conclusions

Electronic supplementary material

Related collections

China Occupational Medicine

Most cited references 43

The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review.

Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy.

Issues surrounding the health economic evaluation of genomic technologies.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 43

Cited by 18

Most referenced authors 382