‘As healthcare professionals we talk about personalised care, person-centred care, personalised medicine, individualised care and precision medicine. These have distinct meanings, but are often confused as the same thing. By confusing these terms, the policy makers, researchers, healthcare workers, and the public miscommunicate. Patients and their doctors need the same lexicon, particularly as patients gain access to their digital personal health records. [BMJ Blog by Dr Jane Wilcock – LINK]
Personalised care refers to a wide holistic discussion with the patient, and at times their loved ones, which considers the patient’s context. It requires specific consultation and management skills.
Chair of RCGP states ‘We know that people with multiple long-term conditions account for about 50% of all GP appointments but the current 10-minute GP consultation just doesn’t allow us enough time to effectively address all their health and well-being needs. Our person-centred care approach suggests ways to give people more choice and control in their lives by providing an approach that is appropriate to the individual’s needs. A new RCGP video highlights this need and involves a conversation shift from asking ‘what’s the matter with you’ to ‘what matters to you’.
“Being person-centred is about focusing care on the needs of the individual. Ensuring that people’s preferences, needs, and values guide clinical decisions, and providing care that is respectful of and responsive to them”
“Personalised care means people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths, needs and preferences.”
Personalised medicine describes a targeted treatment based on a patient’s tumour or genomic markers. In personalised medicine and cancer care it is easy to see how holistic management around the treatment of cancer, sometimes including end of life care, can be confused with specific therapeutic strategies if the terms are not better distinguished.
“Personalised medicine is a move away from a ‘one size fits all’ approach to the treatment and care of patients with a particular condition, to one which uses new approaches to better manage patients’ health and targets therapies to achieve the best outcomes in the management of a patient’s disease or predisposition to disease.” [LINK]
NRC of USA clarifies the situation, “However, there was concern that the word ‘personalized’ could be misinterpreted to imply that treatments and preventions are being developed uniquely for each individual; in precision medicine, the focus is on identifying which approaches will be effective for which patients based on genetic, environmental, and lifestyle factors. The Council therefore preferred the term ‘precision medicine’ to ‘personalized medicine.’
It would seem safer and clearer to describe these new advances more exactly as pharmacogenomics, defined by the USA National Library of Medicine as “the study of how genes affect a person’s response to particular drugs” and secondly as theranostics (or theragnostics).
Personalised medicine will provide opportunities to improve how we treat disease. Based on comprehensive genomic and diagnostic characterisation, different subtypes of patients within a given condition can be identified, and treatment can be tailored to the underlying cause, as illustrated above.
Wilcok staets that “In my view “personalised medicine” should be dropped as a definition for therapeutic and investigative advances. An improvement is the use of the term “precision medicine”, although “pharmacogenetics” and “theranostics” could be adopted as non-confusing terminologies and these terms better define the new branches of medicine. In this way, primary and secondary care specialists, social care workers and the public, and our patients would all understand the matter being discussed. I would ask national and international bodies to agree distinct terminologies and definitions, which clearly distinguish personalised patient-centred care from personalised or precision medicine by widely using terms such as pharmacogenetics and theranostics.