A First Dilemma in Cardiovascular Medicine

Adherence to therapy refers to “the extent to

which patients follow a general strategy of

medical instructions, this implying an active

patient participation about the timing, dosage, and

frequency of taking medications, as well as about

compliance with health-related behavior or lifestyle

modification” (1). Thus, current practice is to advise

the same pharmacological therapy or lifestyle modification

to a wide range of patients who are all presumed

to resemble one another in terms of disease

entity or of risk factor lifestyle category. Conversely,

personalized or individualized therapy is the art and

science of “coupling established clinical–pathological

indices with state-of-the-art molecular profiling, to

create diagnostic and therapeutic strategies precisely

tailored to each patient’s requirements”     llegir més

A Second Dilemma in Cardiovascular Medicine Personalized Medicine Versus Personal Interaction With the Patient
In our rapid and ambitious quest to achieve personalized medicine, mainly driven by technological diagnostics and therapeutics, we are in danger of losing what is truly personal about medicine, that is, the interaction between a doctor and his or her patient. Thus, in a previous Editor’s Page entitled “A First Dilemma in Cardiovascular Medicine: Adherence Versus Personalized Therapy,” I wrote about how poor medication adherence in patients with varied cardiovascular diseases is thwarting efforts to develop improved, personalized treatments that have proven so effective in oncology (1). In this follow-up editorial, I examine the premise that any distraction that interferes with the personal interaction between the physician and his or her patient may impede care. Although technological advances are necessary, they are frequently not used in addition to this cognitive interaction with the patient, but rather as a substitute, wedging themselves in a detrimental manner between this sacred bond. I am not suggesting that we should reject those scientific and technological advances that have served to improve the time to diagnosis and have aided in greater physiological understanding of the human body, but I am simply attempting to caution myself and my colleagues not to get lured in by the promise of personalized medicine. Llegir més...