#EAPM: Age shall not wither them – facing the co-morbidity challenge

| January 17, 2018 | 0 Comments
In this Europe of ageing people, what we call ‘co-morbidity’ or ‘multi-morbidity’ is on the rise, writes European Alliance for Personalised Medicine Executive Director Denis Horgan.

For example, one hundred years ago a single chronic disease would most likely have quickly be-come fatal. You got the disease, it was treated as best as possible, then it was usually game over.

These days, due to major advances in medicine – personalised medicine in particular – many chro-nic diseases can be ‘managed’ to a greater-or-lesser degree. The fact that we now have the wherewithal to treat many previously fatal diseases means that more-and-more people will be har-bouring several manageable illnesses as they grow older.

Obviously, this poses a fiscal burden that all EU Member States are struggling with, but it is argua-bly not the core job of front-line medical professionals to sort out the finances – they are there to save lives and provide as much quality of life for their patients as possible.

Politicians and accountants can do the sums. We may all have to work longer down-the-line to pay for this burden, but there you go for a ‘work-life balance’…

The co-morbidity situation, as suggested, is highest among older people and has been described as currently the most common chronic condition. People suffering from several conditions at the same time – with attendant disability, the need to take lots of different drugs and a struggle for quality of life – are growing in number.

This will not change any time soon and is one of the most profound and important issues facing health-care providers and society in general today. The current state of play in all healthcare sys-tems across the EU means that they are not remotely geared up to handle this issue.

Dealing with this ticking time-bomb is a huge issue and needs to be given the priority it deserves. We need to develop more co-ordinated health services that can handle the varying needs of this growing legion of patients.

This co-ordination needs to operate through various health service sectors that includes, but is not exclusive to, health centres, GPs, hospitals, clinics (in-patient and out-patient) nursing homes, re-habilitation providers, home care services, and even pharmacies.

In essence, there is a need to develop innovative, flexible and on-going care processes that include not just health care, but also take into account and involve social aspects within communities.

Ongoing training for health-care professionals can help here, as well as more out-of-the-silo thinking that can lead to better collaboration between various healthcare sectors. This is not only the case across EU countries but even in regions within them. After all, that’s where every one of us live.

Personalised medicine is helping us to live longer lives and improving the quality of life for those with not just one life-threatening disease but with co-morbidities too. From its genetics-based sci-ence base, personalised medicine can help to tell doctors which medicine will suit which patient – a task that becomes much more complex when multiple chronic diseases are involved.

Meanwhile, research is continuing into all of the many forms of cancer, diabetes, preventable blindness and more – often using aspects of what we have now come to call ’personalised’ or ‘pre-cision’ medicine.

For those not familiar with the term, personalised medicine is a fast-moving field that sees treat-ments and medicines tailored to a patient’s genes, as well as his or her environment and lifestyle.

In a nutshell it aims to give the right treatment to the right patient at the right time, and can also work in a preventative sense.

A number of genome sequencing initiatives have occurred in the last few years to try and capitalise on the potential of cutting-edge genetics.

Within the EU, the soon-to-depart UK has led the way with the 100,000 Genomes Project. This looks at the genome sequences of patients with a rare disease or cancer. It is highly ambitious and looking to develop the requirements for performing whole genome sequencing in a clinical setting (including appropriately educated workforce, clinical pathways and infrastructure) to derive patient benefit.

Better use of our increasing understanding of the genome is recognised as being one of the main determinants of future improvement in healthcare as part of personalised medicine and is already being increasingly deployed in routine clinical practice.

Sequencing of the all the genetic material of an individual – whole genome sequencing – is becom-ing an affordable and achievable test for clinical use and creates a powerful resource for research.

Europe needs to capitalise on the potential for multi-disciplinary collaborative research and stimu-late the life-science industry of the EU. For its part, EAPM has put forward the idea of what we call ‘MEGA’ – the Million European Genomes Alliance. This will involve ‘a coalition of the willing’ member states pulling together to offer up a gene pool from one million individuals.

Coming back to co-morbidities, and from a policy level, Europe very swiftly needs to to do more to support integration that aids care for those with several chronic diseases. It’s an issue, as previously stated, that will not go away away and will certainly get worse unless action is taken right now.

Current care delivery needs to be readjusted and a cure found for the fragmentation that is afflic-ting healthcare services across Europe.

It’s not all about money – we have to find ways to be smarter with the substantial resources already at our disposal, while incentivising research that will give us yet more resources. Bottom line – what is the point of living longer and working for extra years if our healthcare needs are not being adequately addressed through a failure of health services, politicians and, ultimately, society?

To reiterate – today’s patients with co-morbidities are likely to need several care-provider services rather than simply one GP around the corner. So co-ordination between them is vital.

Health-care providers need to address this, and soon, and it comes under the watch of politicians and policymakers at national and, indeed EU level.

Just because the EU does not have competency under the Treaties for individual health-care systems in member states does not mean that the health of all Europeans shouldn’t be a priority. We need health – and that means wealth. Co-morbidity as a side-effect of living longer may be a bitter pill. But it needs to be addressed.


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Category: A Frontpage, EU, European Alliance for Personalised Medicine, Health, Personalised medicine

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