BackgroundPersonalised (or individualised) medicine in the days of genetic research
refers to molecular biologic specifications in individuals and not to a
response to individual patient needs in the sense of person-centred
medicine. Studies suggest that patients often wish for authentically
person-centred care and personal physician-patient interactions, and that
they therefore choose Complementary and Alternative medicine (CAM) as a
possibility to complement standard care and ensure a patient-centred
approach. Therefore, to build on the findings documented in these
qualitative studies, we investigated the various concepts of individualised
medicine inherent in patients’ reasons for using CAM.MethodsWe used the technique of meta-ethnography, following a three-stage approach:
(1) A comprehensive systematic literature search of 67 electronic databases
and appraisal of eligible qualitative studies related to patients’
reasons for seeking CAM was carried out. Eligibility for inclusion was
determined using defined criteria. (2) A meta-ethnographic study was
conducted according to Noblit and Hare's method for translating key themes
in patients’ reasons for using CAM. (3) A line-of-argument approach
was used to synthesize and interpret key concepts associated with
patients’ reasoning regarding individualized medicine.Results(1) Of a total of 9,578 citations screened, 38 studies were appraised with a
quality assessment checklist and a total of 30 publications were included in
the study. (2) Reasons for CAM use evolved following a reciprocal
translation. (3) The line-of-argument interpretations of patients’
concepts of individualised medicine that emerged based on the findings of
our multidisciplinary research team were “personal growth”,
“holism”, “alliance”, “integrative
care”, “self-activation” and “wellbeing”.ConclusionsThe results of this meta-ethnographic study demonstrate that patients’
notions of individualised medicine differ from the current idea of
personalised genetic medicine. Our study shows that the
“personal” patients’ needs are not identified with a
specific high-risk group or with a unique genetic profile in the sense of
genome-based “personalised” or “individualised”
medicine. Thus, the concept of individualised medicine should include the
humanistic approach of individualisation as expressed in concepts such as
“personal growth”, “holistic” or “integrative
care”, doctor-patient “alliance”,
“self-activation” and “wellbeing” needs. This should
also be considered in research projects and the allocation of healthcare
resources.