Representations of Personalised Medicine in Family Medicine: a Qualitative Analysis

Overview

Journal BMC Prim Care

Specialties Health Services
Public Health

Date 2022 Mar 2

PMID 35232380

Authors

Marie S Boyer

Daniel Widmer

Christine Cohidon

Beatrice Desvergne

Jacques Cornuz

Idris Guessous

Daniela Cerqui

Affiliations

Soon will be listed here.

Abstract

Background: The promise of personalised medicine (PM) to transform healthcare has sparked great enthusiasm in the last years. Yet, its lack of consensus around the nature and scope of the concept has ended in terminological confusion amongst the users in primary care. We aimed to investigate the perceptions of doctors and their patients in response to this evolving concept. This present article focuses on the general understanding of personalised medicine, underlining the confusion over the concept.

Methods: Semi-structured comprehensive interviews were conducted with 10 general practitioners (GPs) and 10 of their patients. The purposive sampling took into account the doctor's age, sex, and place of practice (rural/urban); each doctor recruited one patient of the same age and sex. Each interview began with the same open-ended question about the participant's knowledge of the topic, after which a working definition was provided to continue the discussion. Using the grounded theory method, the analysis consisted of open coding, axial coding and selective coding.

Results: From our present analysis focusing on the general understanding of PM, three main themes representing the concept emerged. The first two representations being "centred on the person as a whole" and "focused on alternative and complementary methods", in which the therapeutic relationship was stated as key. The third theme "medicine open to innovation" involved the few participants who had a good understanding of the concept and could associate personalised medicine with genomics. For those who value therapeutic relationship, the risks of accepting innovation could result in "fast-food" medicine and interpersonal barriers.

Discussion: PM is predominantly unfamiliar in family medicine. It is misinterpreted as a holistic or integrative type of medicine. This semantic confusion probably lies in the choice of the label "personalised" or from the lack of a uniform definition for the term.

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References

Vogt H, Green S, Ekstrom C, Brodersen J . How precision medicine and screening with big data could increase overdiagnosis. BMJ. 2019; 366:l5270. DOI: 10.1136/bmj.l5270. View

Cohidon C, Cardinaux R, Cornuz J, Chenal R, Desvergne B, Guessous I . May direct-to-consumer genetic testing have an impact on general practitioners' daily practice? a cross-sectional study of patients' intentions towards this approach. BMC Fam Pract. 2021; 22(1):79. PMC: 8077756. DOI: 10.1186/s12875-021-01428-6. View

Vassy J, Korf B, Green R . How to know when physicians are ready for genomic medicine. Sci Transl Med. 2015; 7(287):287fs19. PMC: 4519005. DOI: 10.1126/scitranslmed.aaa2401. View

Skirton H, Jackson L, Goldsmith L, OConnor A . Are health professionals ready for direct-to-consumer genetic and genomic testing?. Per Med. 2018; 10(7):673-682. DOI: 10.2217/pme.13.71. View

Vogt H, Ulvestad E, Eriksen T, Getz L . Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?. J Eval Clin Pract. 2014; 20(6):942-52. DOI: 10.1111/jep.12251. View

Klonoff D . Personalized medicine for diabetes. J Diabetes Sci Technol. 2009; 2(3):335-41. PMC: 2769744. DOI: 10.1177/193229680800200301. View

NajafZadeh M, Davis J, Joshi P, Marra C . Barriers for integrating personalized medicine into clinical practice: a qualitative analysis. Am J Med Genet A. 2013; 161A(4):758-63. DOI: 10.1002/ajmg.a.35811. View

Zwart H . In the Beginning was the Genome: Genomics and the Bi-textuality of Human Existence. New Bioeth. 2018; 24(1):26-43. DOI: 10.1080/20502877.2018.1438776. View

Bram C, Szucs T . Is It Desirable that I Must Disclose My Genetic Data to Swiss Private Medical Insurances?. Public Health Genomics. 2016; 19(5):251-9. DOI: 10.1159/000448276. View

10.

Mathur S, Sutton J . Personalized medicine could transform healthcare. Biomed Rep. 2017; 7(1):3-5. PMC: 5492710. DOI: 10.3892/br.2017.922. View

11.

Leung L . Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care. 2015; 4(3):324-7. PMC: 4535087. DOI: 10.4103/2249-4863.161306. View

12.

Wasson K, Cherny S, Sanders T, Hogan N, Helzlsouer K . Who are you going to call? Primary care patients' disclosure decisions regarding direct-to-consumer genetic testing. Narrat Inq Bioeth. 2014; 4(1):53-68. DOI: 10.1353/nib.2014.0026. View

13.

Bonter K, Desjardins C, Currier N, Pun J, Ashbury F . Personalised medicine in Canada: a survey of adoption and practice in oncology, cardiology and family medicine. BMJ Open. 2011; 1(1):e000110. PMC: 3191410. DOI: 10.1136/bmjopen-2011-000110. View

14.

Guttmacher A, Collins F . Genomic medicine--a primer. N Engl J Med. 2002; 347(19):1512-20. DOI: 10.1056/NEJMra012240. View

15.

Grant R, Wexler D . Personalized medicine in Type 2 diabetes: what does the future hold?. Diabetes Manag (Lond). 2013; 2(3):199-204. PMC: 3695738. DOI: 10.2217/dmt.12.15. View

16.

Vayena E, Ineichen C, Stoupka E, Hafen E . Playing a part in research? University students' attitudes to direct-to-consumer genomics. Public Health Genomics. 2014; 17(3):158-68. DOI: 10.1159/000360257. View

17.

Manolio T, Chisholm R, Ozenberger B, Roden D, Williams M, Wilson R . Implementing genomic medicine in the clinic: the future is here. Genet Med. 2013; 15(4):258-67. PMC: 3835144. DOI: 10.1038/gim.2012.157. View

18.

Burke W, Trinidad S, Press N . Essential elements of personalized medicine. Urol Oncol. 2013; 32(2):193-7. PMC: 3909672. DOI: 10.1016/j.urolonc.2013.09.002. View

19.

Schleidgen S, Klingler C, Bertram T, Rogowski W, Marckmann G . What is personalized medicine: sharpening a vague term based on a systematic literature review. BMC Med Ethics. 2013; 14:55. PMC: 3878093. DOI: 10.1186/1472-6939-14-55. View

20.

Weller S, Vickers B, Bernard H, Blackburn A, Borgatti S, Gravlee C . Open-ended interview questions and saturation. PLoS One. 2018; 13(6):e0198606. PMC: 6010234. DOI: 10.1371/journal.pone.0198606. View