Introduction to Precision Medicine
To identify the preferred treatment options for individual patients, doctors typically consider a patient’s health conditions, family history, and other factors such as diet or lifestyle. Advances in science and technology have made it possible to add one more piece to the puzzle: genetic information. Through precision medicine – sometimes called individualized medicine, genomic medicine or precision medicine – health care providers can use information about a patient’s genes alongside knowledge about medical history to inform and guide care.
For the UF Health Precision Medicine Program, our initial focus is on helping health care teams routinely use genetic information to help identify which medication or dose is likely to work best for a patient – an area where the scientific evidence is particularly strong for certain medications.
Genes and Medications
Did you know?
The U.S. Food and Drug Administration includes information about genetic factors that influence drug response on the labels of more than 100 medications.
Genes, which are made of DNA, influence everything from eye color and height to health. Genes act as the instruction manual for making all proteins in the body. In some cases, differences in a patient’s genes affect proteins that process certain medications. Genetic differences can affect how well a medication works for a patient or how sensitive the body is to certain side effects. For some medications, screening for genetic variations can help patients receive the proper dose, experience fewer side effects, or avoid drugs that might not work well.
The study of how genes affect an individual’s response to medicines is called pharmacogenomics. More than a decade of pharmacogenomics research has led to a better understanding of why, when, and how to use genetic information to better identify the preferred medication and dose for a patient. In recent years, for example, the U.S. Food and Drug Administration began revising its guidelines for drug labels to include information about genetic variations known to affect the body’s response to a medicine.
Pharmacogenetics in Patient Care
What’s in a name?
Pharmacogenetics is how one gene affects a drug. Pharmacogenomics is how a person’s entire genome, or all of their genes, affects a drug.
UF Health is using the knowledge resulting from pharmacogenomics research to advance health care for our patients. Pharmacogenetic testing provides information about a person’s genetic profile that can be used to help identify the right medicine and the right dose, ideally before a patient starts taking a medication. Pharmacogenetic testing provides an opportunity to reduce the need for trial and error to find which drug regimen works best for a patient.
Guided by scientific and medical experts, UF Health identifies medications for which it is beneficial to perform a genetic test. For patients who may need one of the identified medications, their health care providers may order a simple blood test through the UF Health Precision Medicine Program. The test will show whether a patient has specific genetic variations known to influence the body’s response to that medication. The blood test will be processed by UF Health Pathology Laboratories, similar to other medical or diagnostic tests. The test results will then be stored in a patient’s UF Health electronic medical record along with other information used in his or her care.
Other Types of Genetic Testing
A wide range of laboratory techniques can be used to help health care professionals detect variations in a patient’s genetic profile. A genetic test can be used clinically to determine the cause of some diseases, confirm a suspected diagnosis, predict a patient’s response to a certain treatment, or for many other purposes. As science advances, so do the opportunities for the use of genetic testing to inform, guide, and improve outcomes in patient care.
Protection of Genetic Information
All patient health information, including genetic information, is protected through a health care organization’s patient privacy policies and practices. In addition, the federal Genetic Information Nondiscrimination Act of 2008, or GINA, protects individuals from discrimination by health insurers and employers on the basis of genetic information. The law does not, however, cover life insurance, disability insurance, or long-term care insurance.
Future of Precision Medicine
Rapid advances in science and technology over the last decade have led many to expect that eventually an individual’s personal genome will be part of their medical record, from which information can be pulled to guide personalized treatment decisions. To date, however, there has been minimal translation of this information into clinical practice. To make genomic medicine a reality will require a concerted effort on the part of health systems, informatics experts, laboratories, clinicians, pharmacists, geneticists, and researchers, among others. As part of the UF Clinical and Translational Science Institute, the UF Health Precision Medicine Program is working on multiple fronts to help prepare UF Health and the state of Florida to be leaders in this approach to patient care.