In the third and final episode of Medicine made for you, a series from The Anthill podcast that takes a deep dive into the future of healthcare, we’re exploring how treatment offered by your doctor could become more tailored to you in the future.
In the past, if you walked into a pharmacy and told them you weren’t feeling well, the pharmacist would probably have made up a powder for you – your own personalised medicine. But with the introduction of antibiotics and modern medicine that is much more regulated, this personalised service fell away.
In the 21st century, some researchers are looking at ways to reintroduce some level of personalisation into pharmaceuticals – using 3D printing. Robert Forbes, professor of clinical pharmaceutics at the University of Central Lancashire, is working on a pilot project to 3D print drugs in smaller doses for children. There is even the possibility that similar technology could be used to 3D print polypills containing multiple medications that could replace the pill or dosette boxes which pharmacists prepare for patients who need to take multiple medications each day. He says while it’s still a long way off, he could imagine a world in which devices relay information that’s then used to adjust the regular medications printed by 3D printers:
There may be diagnostics devices that we’re walking around with and information on our bodily functions is being fed automatically to some computer. Then, at a certain time, that information is analysed and … then you would get your medicines printed for the week or the month, and that would give you your personalised, individualised tablets.
Other researchers are looking into more ways to personalise the treatment options available to patients. One is to give GPs the tools to provide patients with more information about their condition, and then make the treatment choice that’s appropriate for them. Mike Messenger, head of personalised medicine and health at the University of Leeds, says:
So each individual will have, maybe, a live dashboard of what their current greatest health risks are. And they will then be able to work with healthcare professionals or other private providers, fitness companies or nutrition companies, to maintain their health and to drive down the areas of greatest risk … So when they do become unwell, in addition to focusing on the symptoms that they present with, they can also take into consideration other risk factors or other sources of information that might inform that particular treatment decision.
Messenger talks about a large lung cancer screening trial that uses electronic healthcare records to identify patients at risk, and then invite them for CT scans in car parks. So far, they’ve identified 40 cases of cancer.
In this episode we’ll also hear about the growth of social prescribing, programmes through which GPs can refer patients to a link worker who can help them access a host of other services in the community to help improve their health and wellbeing.
These programmes are traditionally used for older patients or those with overlapping health conditions who GPs feel would benefit from extra social support. But they are also being used for mental health patients. Social prescribing has attracted more political attention in the UK in recent years and is included in the NHS long-term plan for England.
Christopher Dayson, principal research fellow in the Centre for Regional Economic and Social Research at Sheffield Hallam University, who has been evaluating the social prescribing model in Rotherham, South Yorkshire, explains that it has had a real benefit for patients:
We see an immediate boost for their wellbeing. They get referred to social prescribing and immediately they feel happier. They’re often less isolated, more socially connected. It’s really affecting those who had low wellbeing most positively.
In Rotherham, Dayson says there was also a “6% reduction in emergency inpatient spells and a 13% reduction in accident emergency attendances in the 12 months following the initial referral to social prescribing”.
We also hear from Alison Fixsen, senior lecturer for the School of Social Sciences at the University of Westminster, about some of the potential structural challenges of social prescribing, particularly if the activities people are referred to are run by community organisations that don’t have enough resources. She said it shouldn’t be used as an excuse to neglect public services by putting all the responsibility back onto individuals:
If they haven’t got enough agency, or they’re too vulnerable to be able to either do that activity or to continue it, and if those services in the community are not being properly funded either, but just relying on the goodwill of individuals … then what you’re going to end up with is just another system which is not actually reducing health inequalities.
You can listen here to Medicine made for you part 1, focusing on genes, clinical trials and precision medicine, and here to part 2 on how diets could become more personalised in the future.
The music in this episode is Is That You or Are You You? by Chris Zabriskie, Hallon and FB-01_#2 by Christian Bjoerklund and Serenade for String Orchestra, No 20 by Edward Elgar performed by US Army Strings. Medicine made for you is produced and reported by Holly Squire and Gemma Ware, and hosted by Annabel Bligh for The Anthill podcast. A big thanks to City, University of London, for letting us use their studios.