Precision medicine in Primary Care

In recent years there has been interest to improve personalised care of patients, particularly those with complex health needs. This commonly falls under the umbrella of precision medicine.

The US NIH has defined this as: “Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability genes, environment and lifestyle for each person”

In primary care there are several areas of medicine that would benefit from personalised healthcare. Initial exploration has highlighted the potential role in cardiometabolic disease which collectively causes atherogenic diseases. Specifically, bringing together database work on cardiovascular disease and diabetes, combined with recent genomic advances, offers the opportunity to revisit the stratification of these cardiometabolic conditions from diagnosis to management, the latter including therapeutics and pharmacogenomics.

The organisers are organising a workshop on 28th February 10am - 2pm. This is a hybrid event that takes place in person at the University of Nottingham and via MS Teams.

Objective of workshop

1. Share research and development activity in precision healthcare
2. Align areas of mutual research interest
3. Develop collaborative research in focused areas e.g. work towards 2022 SPCR FR6 bid and/or other funding opportunities
4. Identify long-term programme of work and future external funding with appropriate partners such as NICE

 Agenda of the workshop to be confirmed. It will include five-minute taster presentations on:

• Overview of precision medicine in diabetes – Bev Shields
• Database work on characterising diabetes & CVD - Evan Kontopantelis
• Pharmacogenetics in Diabetes- Ewan Pearson
• Machine learning & other innovative methodologies to use in database research – Ralph Akyea

To register or for more information, please contact Stephanie Gallimore via MS-SPCR-Support@exmail.nottingham.ac.uk

After the workshop

The organisers of the workshop will establish a group interested in precision medicine within primary care. 

Several groups are looking at precision medicine, but this group will differ by looking, in parallel, at both reclassification and clustering approaches through database research and importantly, the steps required to generate the necessary evidence and implement into primary care. Although the core steering group’s initial discussion has been around cardio-metabolic disease, we anticipate the precision medicine healthcare group will also develop research in other areas

Overall aim of the group is to identify the right care for the right person at the right time for patients in primary care, with initial focus on cardiometabolic disease.

Several research questions exist in this space, that have funding opportunities, can lead to patient benefit, and are of interest to the general public: 

• Can we improve prescribing decisions in clinical care in Type 2 diabetes through the use of more personalised treatment selection algorithms?
• Can pharmacogenomics panels improve therapeutic outcomes in patients with atherogenic profiles?
• Map disease trajectories and incorporate them in risk prediction modelling (e.g. where are individuals on this disease trajectory and can this be modified)
• Consider bringing comorbidities (concordant, discordant) and trajectories into management, ideally creating more personalised treatment guidelines.