Application of personalized medicine to chronic disease: a feasibility assessment
Abstract Personalized Medicine has the potential to improve health outcomes and reduce the cost of care; however its adoption has been slow in Canada. Bridgepoint Health is a complex continuous care provider striving to reduce the burden of polypharmacy in chronic patients. The main goal of the stud...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2013-12-01
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| Series: | Clinical and Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/2001-1326-2-16 |
| _version_ | 1818173802879647744 |
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| author | Ruslan Dorfman Zayna Khayat Tammy Sieminowski Brian Golden Renee Lyons |
| author_facet | Ruslan Dorfman Zayna Khayat Tammy Sieminowski Brian Golden Renee Lyons |
| author_sort | Ruslan Dorfman |
| collection | DOAJ |
| description | Abstract Personalized Medicine has the potential to improve health outcomes and reduce the cost of care; however its adoption has been slow in Canada. Bridgepoint Health is a complex continuous care provider striving to reduce the burden of polypharmacy in chronic patients. The main goal of the study was to explore the feasibility of utilizing personalized medicine in the treatment of chronic complex patients as a preliminary institutional health technology assessment. We analyzed stroke treatment optimization as a clinical indication that could serve as a “proof of concept” for the widespread implementation of pharmacogenetics. The objectives of the study were three‐fold: Review current practice in medication administration for stroke treatment at Bridgepoint Health Critically analyze evidence that pharmacogenetic testing could (or could not) enhance drug selection and treatment efficacy for stroke patients; Assess the cost‐benefit potential of a pharmacogenetic intervention for stroke. Review current practice in medication administration for stroke treatment at Bridgepoint Health Critically analyze evidence that pharmacogenetic testing could (or could not) enhance drug selection and treatment efficacy for stroke patients; Assess the cost‐benefit potential of a pharmacogenetic intervention for stroke. We conducted a review of stroke treatment practices at Bridgepoint Health, scanned the literature for drug‐gene and drug‐outcome interactions, and evaluated the potential consequences of pharmacogenetic testing using the ACCE model. There is a substantial body of evidence suggesting that pharmacogenetic stratification of stroke treatment can improve patient outcomes in the long‐term, and provide substantial efficiencies for the healthcare system in the short‐term. Specifically, pharmacogenetic stratification of antiplatelet and anticoagulant therapies for stroke patients may have a major impact on the risk of disease recurrence, and thus should be explored further for clinical application. Bridgepoint Health, and other healthcare institutions taking this path, should consider launching pilot projects to assess the practical impact of pharmacogenetics to optimize treatment for chronic continuous care. |
| first_indexed | 2024-12-11T19:34:18Z |
| format | Article |
| id | doaj.art-ce8cfdcfd6314ea3b849fd3ad5836f11 |
| institution | Directory Open Access Journal |
| issn | 2001-1326 |
| language | English |
| last_indexed | 2024-12-11T19:34:18Z |
| publishDate | 2013-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Medicine |
| spelling | doaj.art-ce8cfdcfd6314ea3b849fd3ad5836f112022-12-22T00:53:12ZengWileyClinical and Translational Medicine2001-13262013-12-0121n/an/a10.1186/2001-1326-2-16Application of personalized medicine to chronic disease: a feasibility assessmentRuslan Dorfman0Zayna Khayat1Tammy Sieminowski2Brian Golden3Renee Lyons4The Rotman School of ManagementThe University of TorontoTorontoONCanadaThe Rotman School of ManagementThe University of TorontoTorontoONCanadaNeurorehabilitationBridgepoint HospitalTorontoOntarioCanadaInternational Centre for Health InnovationRichard Ivey School of BusinessUniversity of Western OntarioLondonONCanadaBridgepoint Chair in Complex Chronic Disease Research, TD Scientific DirectorBridgepoint Collaboratory for Research and InnovationTorontoOntarioCanadaAbstract Personalized Medicine has the potential to improve health outcomes and reduce the cost of care; however its adoption has been slow in Canada. Bridgepoint Health is a complex continuous care provider striving to reduce the burden of polypharmacy in chronic patients. The main goal of the study was to explore the feasibility of utilizing personalized medicine in the treatment of chronic complex patients as a preliminary institutional health technology assessment. We analyzed stroke treatment optimization as a clinical indication that could serve as a “proof of concept” for the widespread implementation of pharmacogenetics. The objectives of the study were three‐fold: Review current practice in medication administration for stroke treatment at Bridgepoint Health Critically analyze evidence that pharmacogenetic testing could (or could not) enhance drug selection and treatment efficacy for stroke patients; Assess the cost‐benefit potential of a pharmacogenetic intervention for stroke. Review current practice in medication administration for stroke treatment at Bridgepoint Health Critically analyze evidence that pharmacogenetic testing could (or could not) enhance drug selection and treatment efficacy for stroke patients; Assess the cost‐benefit potential of a pharmacogenetic intervention for stroke. We conducted a review of stroke treatment practices at Bridgepoint Health, scanned the literature for drug‐gene and drug‐outcome interactions, and evaluated the potential consequences of pharmacogenetic testing using the ACCE model. There is a substantial body of evidence suggesting that pharmacogenetic stratification of stroke treatment can improve patient outcomes in the long‐term, and provide substantial efficiencies for the healthcare system in the short‐term. Specifically, pharmacogenetic stratification of antiplatelet and anticoagulant therapies for stroke patients may have a major impact on the risk of disease recurrence, and thus should be explored further for clinical application. Bridgepoint Health, and other healthcare institutions taking this path, should consider launching pilot projects to assess the practical impact of pharmacogenetics to optimize treatment for chronic continuous care.https://doi.org/10.1186/2001-1326-2-16StrokeStroke treatmentTIAPharmacogeneticsStatinsClopidogrel |
| spellingShingle | Ruslan Dorfman Zayna Khayat Tammy Sieminowski Brian Golden Renee Lyons Application of personalized medicine to chronic disease: a feasibility assessment Clinical and Translational Medicine Stroke Stroke treatment TIA Pharmacogenetics Statins Clopidogrel |
| title | Application of personalized medicine to chronic disease: a feasibility assessment |
| title_full | Application of personalized medicine to chronic disease: a feasibility assessment |
| title_fullStr | Application of personalized medicine to chronic disease: a feasibility assessment |
| title_full_unstemmed | Application of personalized medicine to chronic disease: a feasibility assessment |
| title_short | Application of personalized medicine to chronic disease: a feasibility assessment |
| title_sort | application of personalized medicine to chronic disease a feasibility assessment |
| topic | Stroke Stroke treatment TIA Pharmacogenetics Statins Clopidogrel |
| url | https://doi.org/10.1186/2001-1326-2-16 |
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