Larina Vera
Russian national research medical university
Title: Problems and perspectives of personalized medicine
Biography
Biography: Larina Vera
Abstract
In Russia, as in many countries around the world, there was an individualized and paternalistic approach to the treatment of the patient. In the past, it was based on the personal doctor’s experience, the doctor-patient relationship and often the patient's socioeconomic status. The priority of individualized treatment began to give way to clinical guidelines based on evidence-based medicine in relation to the introduction of the principles of "industrialized" and evidence-based medicine into practice. At the same time, over the past decade it has become clear that such approaches cannot resolve the complex of problems associated with the patient's "burden of disease".
Awareness of the need to minimize the burden of treatment for the patient, his family and the health care system has emerged in relation to the development of new technologies, increased longevity, increase patients number with multimorbidity and fragility, emergence of research results indicating that the same method of treatment (drug) can affect the patient in different ways. More and more specialists are talking about the need for individualized approach in the choice of tactics for managing the patient, taking into account the biological characteristics, the possibilities of medicine and many other non-medical factors (ethical, social, financial).
A lack of knowledge is a significant problem for the introduction into the clinical practice of personalized medicine despite of their geometric growth at the present time. In fact, there are no randomized studies, that all the way of treatment and diagnostic methods with an infinite variability of multimorbidity are evaluated, there is no possibility to use in clinical work all the accumulated knowledge in the world (this the limited capabilities of a doctor and even a multidisciplinary team; lack of a common language of communication, a database of such information, rapid access to it, taking into account the individual needs of the patient), only the beginning of the selection of treatment taking into account genetic and epigenetic factors.