personalised medicine: eligible or not? (WC2014-021)

Background

Starting date: 01/09/2014

Background

Genetic information can contribute to identification of subgroups within the population that are more prone to develop disease, i.e., risk stratification in personalised prevention. It can also contribute to identification of subgroups of patients for which treatment is more or less effective, or may lead to adverse effects, i.e., stratified or precision medicine.

This project will focus on the latter, the contribution of genetic information to personalised medicine in treatment of disease, thereby acknowledging genotype/phenotype drug interactions.

In primary care, however, generally low risk drugs are prescribed and toxicity and efficacy are almost always determined based on phenotypic information only. As a consequence, patients may experience shorter (weeks) or longer (months, years) time periods of inconvenience until treatment is optimised. Pre-emptive genotyping in cases where the drug-induced phenotype is caused by a polymorphic gene may immediately guide drug treatment and result in better informed therapeutic decisions, before undesirable phenotypes are being developed, potentially gaining benefit for many years in a lifetime of a patient. Given the large number of patients treated in primary care, the impact of pharmacogenetic testing may be considerable from a population perspective. It is therefore critical to investigate public health implementation of pharmacogenetics guided treatment in primary care.