How P4 Medicine Will Transform Healthcare and Society, Part 2By Gustavo Rodríguez | Fri, 08/19/2022 - 09:00
P4 medicine is a new way of approaching health, which focuses on the treatment and prevention of diseases that involves patients, doctors, products and places. It can be used to address all important aspects of the patient experience, from diagnosis to recovery, as it is tailored to each patient's specific situation, allowing for personalized care.
- Participatory:the doctor-patient relationship and the active and central role of the patient is fundamental. We can achieve this through digital platforms that promote patient-care relationships. The opportunity to be able to communicate in this way is of great help in diagnosing any disease.
- Personalized:taking into account the condition, behavior and previous medical history, among other aspects of each patient. It is very useful when deciding the treatment.
- Predictive:genomic, proteomic and metabolomic studies allow us to predict diseases that may occur long before the patient presents any symptoms. Undoubtedly, since the conclusion of the Human Genome Project and the appearance of omics sciences together with technological advances, they have represented gigantic advances that never cease to amaze us.
- Preventive:obtaining data, diagnosing any disease to be aware of its evolution and educating the patient to make the necessary changes to permanently implement healthy habits, which is an excellent preventive tool, and currently, we have the help of technology.
Drugs have a different response depending on the person who has ingested them. Some of them work normally, others usually have a very good response, while in others it does not have an effect and in some it can result in negative effects; this is completely normal, as medications are designed to treat symptoms in most people; however, our genetic makeup and the environment we were exposed to determine the effectiveness of treatments.
Similarly, the above applies to foods, whose nutrients may be necessary in greater or lesser amounts depending on the individual. Some people might even need to eliminate certain foods that are exclusively harmful (for example, celiac disease or lactose intolerance are among the most well-known conditions that make it almost impossible to eat foods containing gluten or lactose, respectively). In addition to the above, the results of physical activity are affected by our genetic makeup. Chung et al. (2019) evaluated more than 3,000 healthy volunteers who were subjected to the same exercises, with the same intensity and during the same times. They found that there was a variation of 72 percent due to genetics in those who performed muscular exercise, 44 percent aerobic exercise and 10 percent anaerobic. Other factors that influenced the differences in results were diet, recovery time and injuries.
Big Data and Tech
Previously, it has already been mentioned that one of the foundations of P4 medicine is the retrieval and analysis of big data to apply these interpretations for patient care. The concept of big data does not describe a specific amount of data; it refers to a quantity of data so large or so complex that the traditional methods used for its analysis are not helpful in obtaining answers. Therefore, the new analysis models allow obtaining results with greater medical meaning, which is to say that big data allows an early diagnosis (it refers to the identification of people who suffer from cancer that had not been detected due to the absence of symptoms), prognosis and treatment planning; Similarly, it not only contributes to the timely detection of serious diseases but also represents a reduction in medical expenses (Moreno-Carriles, 2018).
Among other technologies that have made the emergence of P4 medicine possible is the implementation of online medical appointments, without the patient having to waste time traveling, as well as the multiple "virtual assistants" that we can download on our cellphones, and some of the applications are free (Moreno-Carriles, 2018). There even has been an impact on the reach of health information in an easy way through publications on social networks and podcasts that arouse concern for the healthcare of users.
The Transformation of the Health Sector and Society
Flores and collaborators (2013) list the transformations that the health sector and society have undergone with the appearance of P4 medicine:
- The use of big data. New models for data analysis will offer us results that are increasingly closer to reality, allowing timely diagnosis, prevention of serious illnesses and better treatments.
- It is not limited to relieving the symptoms but to finding the origin. The ailments are treated from the root, taking into account the different factors that could influence the development of a condition.
- Boosting biomedical innovation. The new knowledge acquired thanks to systems biology could solve questions that previously had no conclusive answers.
- Healthcare is not limited to hospitals. It represents a change in our way of thinking and in our habits, since we are involved in taking care of ourselves and even in the health of others around us, since chronic diseases are the result of a series of decisions and bad habits.
- The wellness industry. The appearance of these health products and services seek to improve the quality of life of users and help them prevent any chronic disease that could have developed if they had not had the support of this healthcare service.
P4 medicine is defined as a "new generation of services designed for people who want to take charge of their health and well-being." It allows us to control a wide variety of aspects of our health, which we previously thought were impossible, making us think that developing conditions was due to bad luck or that life hates us, but not anymore. Now, we have the opportunity to be aware of the effect we are having on our health.
Preventive medicine allows us to have a global panorama of our health, determined by genetic, environmental, mental and behavioral factors; as these factors tend to interact at different levels to ultimately affect physical health. Although it might seem that we are still a long way from applying P4 medicine, this is not the case. The use of this type of medicine is already a reality, although there are still details to be polished. Advances in technology, which are constantly emerging, are making valuable contributions to medical advancement.
At nutriADN functional medicine clinics (www.nutriadn.com), P4 medicine is practiced and its reach covers all of Mexico and some countries in Latin America. You can learn more on our website about the innovative laboratory analysis, consultations, programs and seminars for health professionals that encourages them to apply this “new generation” medical practice in their consultation. If you would like to partner with us, you can learn more at https://www.nutriadn.com/partners.
Cardinal-Fernández, P., Nin, N., Ruiz-Cabello, J., & Lorente, J. A. (2014). Systems medicine: a new vision of clinical practice. Archives of Bronchopulmonology, 50(10), 444–451.
Chung, H. C., Keiller, D. R., Roberts, J. D., & Gordon, D. A. (2021). Do exercise-associated genes explain phenotypic variance in the three components of fitness? a systematic review & meta-analysis. PlOS one, 16(10), e0249501.
Flores, M., Glusman, G., Brogaard, K., Price, N. D., & Hood, L. (2013). P4 medicine: how systems medicine will transform the healthcare sector and society. Personalized Medicine, 10(6), 565-576.
Moreno-Carriles, R.M. (2018). Big data, but what is it? Angiology. doi:10.1016/j.angio.2018.05.001
Sobradillo, P., Pozo, F., & Agustí, Á. (2011). Medicine P4: the future just around the corner