Personalised (or individualised) medicine has been a bit of a buzz word in pharmaceutical research for a while now. It all stems from the problem that no-one reacts in quite the same way to pharmaceutical drugs. What will be a miracle cure in one person, is likely to have no effect in five, some effect in another five, and cause horrible side effects in a few others. This means that doctors trying to find the right treatment for a patient will usually have to try a few options before they find one that the patient is happy with, or not totally unhappy… To solve this, pharmaceutical companies have been working on tailoring drugs to specific genomes and particular biomolecular markers. These drugs will be specific to individuals and hopefully cut down on some of the trial and error of prescribing. But, how do we know if this is the best route forward?
A study recently published in BMC Complementary and Alternative Medicine (http://www.biomedcentral.com/1472-6882/13/124) discussed whether these advances in drug making really were addressing patients’ needs and wants. The process of drug development is totally removed from the ordinary patient; they don’t get to provide any input into what is developed or what they would like to be able to access and how they would like to be treated by their practitioners. The authors propose that many people turn to complementary and alternative medicine (CAM) as a way to access better patient-centered care, and they undertook a meta-ethnographic study into why people use CAM and what they think individualised medicine really means. In this study, individualised medicine was found to be associated in patients’ minds with “holism” and being able to have a choice about treatment (sharing in the decision-making process). In a holistic view of health, the whole body, mind and soul are taken as a whole and any treatment or intervention is focused on addressing all the parts together. Other aspects of CAM that were considered beneficial included, being able to take responsibility for your own health, developing a good therapeutic relationship with a practitioner, having tailored care, and having more time devoted to their interactions with practitioners.
Ultimately, CAM enables people to move away from paternalistic care, to create a shared narrative about their illness with someone who has the time and inclination to help people take control of their own health, access information, and stop feeling like a victim to disease. Chronic and serious illness have far reaching effects on a person’s overall wellbeing and many patients would rather see this as an opportunity for “personal growth” that can be enabled by their therapeutic relationship with a practitioner, than something that needs to be dealt with separately from the treatment of the disease or disorder. The authors of the study concluded that genome-based medicine may be able to address the need for more effective treatments with fewer side effects, but falls short of providing the all round holistic care that patients would ideally like to receive.