Success Factors and Barriers in Combining Personalized Medicine and Patient Centered Care in Breast Cancer. Results from a Systematic Review and Proposal of Conceptual Framework

Journal of Personalized Medicine

Rossella Pellegrino¹  Carolina Castagna²  Stefania Boccia²  Alisha Morsella²  Antonio Giulio de Belvis²  Roberta Pastorino² 

[1] Clinical Pathways and Outcome Evaluation Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Via della Pineta Sacchetti 217, 00168 Rome, Italy;Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;

关键词: personalized medicine;    Patient Centered Care;    breast cancer management;    organizational model;    systematic review;   

DOI  :  10.3390/jpm11070654

来源: DOAJ

【 摘 要 】

Breast Cancer (BC) is the leading cause of death due to cancer in women. Ensuring equitable, quality-assured and effective care has increased the complexity of BC management. This systematic review reports on the state-of-the art of available literature investigating the enactment of personalized treatment and patient-centered care models in BC clinical practice, building a framework for the delivery of personalized BC care within a Patient-Centered model. Databases were searched for articles (from the inception to December 2020) reporting on Patient-Centered or Personalized Medicine BC management models, assessing success factors or limits. Out of 1885 records, 25 studies were included in our analysis. The main success factors include clearly defined roles and responsibilities within a multi-professional collaboration, appropriate training programs and adequate communication strategies and adopting a universal genomic language to improve patients’ involvement in the decision-making process. Among detected barriers, delays in the use of genetic testing were linked to the lack of public reimbursement schemes and of clear indications in timing and appropriateness. Overall, both care approaches are complementary and necessary to effectively improve BC patient management. Our framework attempts to bridge the gap in assigning a central role played by shared decision-making, still scarcely investigated in literature.

【 授权许可】

Unknown