The Patient-Centered Decision System as per the 4Ps of Precision Medicine

Baiardini, Ilaria; Heffler, Enrico

doi:10.1016/b978-0-12-813471-9.00024-4

Cited by 9 publications

(4 citation statements)

References 34 publications

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“…Empowerment in the context of health care emerges out of the promotion of independence of service users and the restriction of disability and incapacitation, at both personal and social levels [ 12 ]. One of the main methods of empowering people with chronic illness is through reinforcement of their capacity to manage the illness themselves (ie, self-management capacity) [ 12 ], while reducing health care professionals’ involvement to the minimum possible [ 13 ]. Enhancement of ill health self-management capacity is achieved through educational and training interventions [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

et al. 2021

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Background Addressing the enhancement of ill health self-management skills in adults diagnosed with bipolar disorder may be considered an important intervention for health care systems worldwide. Objective This protocol describes the study “Management of my Bipolarity” (MoB), which aims to develop an educational intervention for adults with bipolar disorder and assess its effectiveness. The objectives include (a) a literature review on bipolar disorder educational interventions; (b) a qualitative exploration of the educational needs of people with bipolar disorder; (c) development of an educational intervention based on objectives (a) and (b) (ie, the MoB educational intervention); and (d) exploration of the effectiveness of the intervention regarding participants’ knowledge of their mental health condition and enhancement of their ill health self-management skills. The MoB educational intervention will consist of an in-person and a web-based intervention in the form of a digital platform. Methods The proposed interventional study is a combination of a qualitative and a quantitative design (mixed methods study). A focus group and content analysis will be implemented for the qualitative assessment of the educational needs of adults with bipolar disorder. The intervention will be developed based on the qualitative data of the study and relevant literature. The effectiveness of the acquired knowledge and self-management skills will be assessed according to (a) substance use behavior, (b) health locus of control, (c) impulse control, (d) adherence to pharmacotherapy, (e) relapse prevention, (f) improvement of quality of life, and (g) bipolar disorder knowledge level via structured instruments in the quantitative part of the study using descriptive and inferential statistics (SPSS version 24.0). Results A total of 13 patients with bipolar disorder have been interviewed (8 women, 5 men) to identify educational needs to be covered through the intervention. Moreover, a literature review on bipolar disorder educational interventions has been completed. These data have been incorporated in the design of the MoB in-person intervention and the digital platform. The digital platform is live, and the development of the MoB in-person intervention was completed at the end of 2020. The recruitment of the participants for the intervention (40 patients) and the control group (40 patients) began during the first semester of 2021. Moreover, by tracking the platform for 1.5 years, we have recorded that 2180 users have visited the platform with an average session duration of almost 2 minutes. Mobile and tablet devices are being used by 70% of the visitors. Conclusions Since new parameters regarding educational interventions will be explored, these findings are expected to provide evidence that participation in structured educational interventions offers patients the opportunity to improve adherence to pharmacotherapy and increase their quality of life. Trial Registration ClinicalTrials.gov NCT04643210; https://clinicaltrials.gov/ct2/show/NCT04643210 International Registered Report Identifier (IRRID) DERR1-10.2196/25168

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Section: Introductionmentioning

confidence: 99%

Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

et al. 2021

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“…However, before being applied in clinical practice, these studies typically undergo a complex process known as multi-omics. For example, the progression of a study involving multi-omics in metabolic diseases is usually followed by: (1) genomics for determining an individual's complete genome and developing biomarkers; (2) pharmacogenomics to predict the treatment efficacy by analyzing genetic variants; (3) transcriptomics, studying external factors that influence gene expression and affect the patient's phenotype; (4) epigenomics, to examine mechanisms that regulate gene expression; (5) proteomics, which focuses on studying protein function; (6) pharmacoproteomics, applying proteomics to pharmacology; (7) metabolomics, to identify metabolism variants; (8) pharmacometabolomics, applying metabolomics to pharmacology in order to support the development of personalized medicine by measuring metabolic phenotypes and drug metabolism; and finally, (9) integrating multi-omics, the integration and interpretation of the diverse omics, a complex exercise to apply in clinical routine [19].…”

Section: Omics In Advancing Clinical Decision-makingmentioning

confidence: 99%

“…Therefore, precision medicine addresses the growing need for precise and effective treatments, aligning with the cornerstones of the clinical medicine model, the four Ps: predictive, preventive, personalized, and participative [ 9 ]. This shift toward a patient-centered clinical decision-making system marks a transition from reactive medicine based on gold standards to patient-specific diagnostics and therapeutics [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Advancing Precision Medicine: A Review of Innovative In Silico Approaches for Drug Development, Clinical Pharmacology and Personalized Healthcare

Marques,

Costa,

Pereira

et al. 2024

Pharmaceutics

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The landscape of medical treatments is undergoing a transformative shift. Precision medicine has ushered in a revolutionary era in healthcare by individualizing diagnostics and treatments according to each patient’s uniquely evolving health status. This groundbreaking method of tailoring disease prevention and treatment considers individual variations in genes, environments, and lifestyles. The goal of precision medicine is to target the “five rights”: the right patient, the right drug, the right time, the right dose, and the right route. In this pursuit, in silico techniques have emerged as an anchor, driving precision medicine forward and making this a realistic and promising avenue for personalized therapies. With the advancements in high-throughput DNA sequencing technologies, genomic data, including genetic variants and their interactions with each other and the environment, can be incorporated into clinical decision-making. Pharmacometrics, gathering pharmacokinetic (PK) and pharmacodynamic (PD) data, and mathematical models further contribute to drug optimization, drug behavior prediction, and drug–drug interaction identification. Digital health, wearables, and computational tools offer continuous monitoring and real-time data collection, enabling treatment adjustments. Furthermore, the incorporation of extensive datasets in computational tools, such as electronic health records (EHRs) and omics data, is also another pathway to acquire meaningful information in this field. Although they are fairly new, machine learning (ML) algorithms and artificial intelligence (AI) techniques are also resources researchers use to analyze big data and develop predictive models. This review explores the interplay of these multiple in silico approaches in advancing precision medicine and fostering individual healthcare. Despite intrinsic challenges, such as ethical considerations, data protection, and the need for more comprehensive research, this marks a new era of patient-centered healthcare. Innovative in silico techniques hold the potential to reshape the future of medicine for generations to come.

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“…The first three Ps were introduced at the beginning of the century, then extended with the fourth one in 2008 by the molecular biologist and oncologist Leroy Hood [19]. This extension has been labeled as "a driving force for revolutionizing healthcare", since the individual's participation is the key to put into practice the other three aspects [20].…”

Section: Introductionmentioning

confidence: 99%