Muir Gray e.a. hebben in 2018 geprobeerd helderheid te brengen in de verschillende termen die worden gebruikt voor gepersonaliseerde zorg. Zij onderscheiden Patient-centred care, Personalised medicine en Precision medicine. Over patient-centred care halen zij met instemming Don Berwick aan, die in 2009 drie kernelementen noemt:

1. The needs of the patient come first.
2. Nothing about me without me.
3. Every patient is the only patient.

Zij komen vervolgens tot de volgende definities.

Patient-centred care

“The experience (to the extent the informed, individual patient desires it) of transparency, individualization, recognition, respect, dignity, and choice in all matters, without exception, related to one’s person, circumstances, and relationships in health care.” (Ontleend aan Berwick)

Personalised medicine

“The clinician’s job is therefore to relate this evidence to the unique clinical condition of the patient and to create a con-text in which the patient can be allowed to reflect on their values, the values they attach to different options that may occur, both good and bad, and the value they place on risk-taking or risk avoidance.” (Gebaseerd op Rothwell)

Precision medicine

“We define precision medicine as the provision of care for diseases that can be precisely diagnosed, whose causes are understood, and which consequently can be treated with rules-based therapies that are predict- ably effective.” (Naar Christensen)

Ordening

Zij ordenen de begrippen in een Venn-diagram dat wij bewerkten tot de figuur hiernaast.

Richting

Overigens beoogt de publicatie ook richting te geven aan de ontwikkelingen:

“… the belief that you are delivering patient-centred care does not ensure that it is actually delivered. Evidence suggests that many, if not most, services need a significant change in culture and new systems to ensure that patient-centred care is delivered.” (Gray et al., 2018)

Gray M, Gray J, Howick J. Personalised healthcare and population healthcare. J R Soc Med. 2018;111(2):51-56. doi:10.1177/0141076817732523

Gray verwijst naar:

Berwick DM. What ‘Patient-Centred’ should mean: confessions of an extremist, 2009. 

Rothwell PM. Treating Individuals: From Randomised Trials to Personalised Medicine. Edinburgh: Elsevier, 2007, p.xi.

Christensen CM. The Innovator’s Dilemma. New York: Harper Business Essentials, 2003, p. 45 and 56.