Precision medicine is about moving away from the concept of “One-size-fits-All” when selecting medications for patients and recognizing that individuals respond differently to the same medicine.
There is usually a wide range of drugs available to treat each medical condition. The clinicians typically exercise due diligence when selecting a drug and take many factors into consideration to achieve efficacy with minimal adverse effects. They review symptoms, demographics, other medical conditions, other medicines, potential side effects, contraindications, allergies, cost and much more. However, despite the clinician’s best efforts, a medication may produce the desired benefits with minimal side effects in some individuals but fail to yield the desired effects or have unacceptable side effects in others.
This demonstrates that ONE SIZE DOES NOT FIT ALL. This disparity in response to the same medication can be attributed to the factors mentioned above and others such as:
- Genetics
- Lifestyle
- Environment
Pharmacogenomics uses the information about the correlation between genetics and drugs to guide the prescriber in the selection of medication tailored to an individual’s genetic make-up. This is a major component of precision medicine.
Pharmacogenomics is particularly important in streamlining the process of selecting mental health drugs. Individuals sometimes have to try several antidepressants before finding the one that works. As a pharmacist, I have observed clinicians sometimes start and discontinue several antidepressants until they find one that works best for an individual. It is imperative to avoid delays in finding appropriate therapy that yield beneficial outcomes so utilizing pharmacogenomic testing is highly recommended.
Most common areas where there is evidence of precision medicine improving therapeutic outcomes include:
- Pain management
- Anticoagulation
- Cardiology
- Psychiatry
- Oncology
- Infectious disease
Precision medicine is about tailoring medication needs to an individual’s circumstances. Pharmacogenomics is the gateway to precision medicine and should be incorporated into a patient’s pharmaceutical care plan where considered beneficial.
