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Team Approach in Patient Care

Program: Is Your Medication Right For You?
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Dr. McLeod:

Well, there will be. At the moment there's a lot of interest and a lot of desire for patients to be more of the focus in trying to choose medicine. Currently there are individuals at many centers across the world who is interested in this topic, but it takes a whole team approach to really pull it off. And medicine has really gone to the direction where it's no longer just one doctor that makes all the decisions. You have someone looking at the imaging, the x-rays and such, someone who is looking at the way the pathology is being done if you have a tissue sample. Many different aspects of a patient's care requires these teams to come together.

And it's the same with thinking about the therapy. In some situations there is only one doctor that's able to help make the choice, but in the more informed situation they have teams of people coming together to really try to drive the discoveries that we're making in science in to the point where every patient can benefit from them. So this institute and the ones that will likely follow over the next decade are really trying to focus in on how we take scientific discoveries and allow them to progress rapidly to the point where every patient can benefit directly from them.

Andrew Schorr:

Okay. I think I get what individualized therapy means, and that's part of your institute, but help us understand the simple definition for pharmacogenomics.

Dr. McLeod:

We've known for a long time that we inherit things from our parents. My children look more like me than they do you, and that's a good thing for you, bad thing for them, but we know that inheritance in terms of outward features. The same occurs in terms of inward features, such as the ability of the liver to break down a medicine or how a medicine could be transported from the stomach into the body or the amount of a target that might be found in a particular tissue. So the genetics has an influence on the way we respond to medicines in the same way that it has an influence on our outward appearance and many of our other features. So pharmacogenomics is really just taking many of the new technologists that have come from the human genome project and applying them to individuals.

So when you look at a patient you can see how they feel, you can ask them how they feel. Now with some of the new technologists you can actually look at their genes and understand a little bit more about how they are going to react to a medicine, whether they might have some extra side effects that you want to avoid, whether a medicine is not the right one for them and needs to be switched to an alternate choice. So it's really just taking these tools from the human genome and applying them directly to an individual patient's care.

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