Personalised Medication and Shared Care Records could save lives and money
18 September 2024
Using Shared Care Records (SCR) to identify patients in need of a more personalised approach to cholesterol medication could prevent over 370 heart attacks and strokes every year, saving the NHS more than £9m.
Graphnet Director, David Grigsby says SCRs should be “the focus now” to help GPs and NHS trusts find those in need of specialised medication and provide “care tailored to people’s personal needs and circumstances.”
He said: “The emphasis in health and care, particularly since Covid-19, has been on taking preventative, proactive, data-led action – rather than being the ambulance at the bottom of the hill.
“Shared care records contain the insights that are needed to achieve that mission. It is an important development in providing care tailored to people’s personal needs and circumstances across all health and care partners.
“Shared care records will become more valuable as more information from different sources is included, and more care professionals are able to access it.
“Creating, rolling out and recording the results from a greater range of care plans will also play a crucial part. That needs to be the focus now.”
Finding those in need of personalised medication
Many people will require personalised medication as not every person is the same – and neither are their symptoms, medical history, genetics or current situation.
Personalised medicine – sometimes called ‘precision medicine’ - involves tailoring prescriptions, treatment programs and other medical processes to the individual patient based on the data and records available.
It can often be based on genetic data, but as we move forward, detailed analysis of patient data and detailed medical records are providing useful ways to provide personalised approaches to medication and care.
And the more shared data healthcare providers have access to, the more personalised the care can be.
An NHS trust - using shared care technology developed by Graphnet - identified 18,904 people across 170 practices in Greater Manchester eligible for receiving novel therapies to help reduce their cholesterol, according to a Health Innovation Manchester report.
This approach to personalised medicine – which combined the novel therapies with standard statin treatment and lifestyle changes - helped to prevent 80 heart attacks and strokes over five years saving the NHS £2m in direct costs.
If this one approach was applied across the UK’s population, it could potentially prevent over 370 heart attacks and strokes every year, saving the NHS more than £9m annually.
A case finding tool was developed to allow GPs to easily find patients who required a lipids review and could be eligible for a more novel therapy. This tool was integrated with GP practice clinical systems, and searches replicated in the GM Care Record.
How SCRs could boost personalised medication
Graphnet has been working to show how using a shared care approach can have measurable impacts on people’s health through a more focussed and personalised approach to medication and care.
In Wirral, another service was launched to use the Graphnet shared care approach to provide a personalised prehabilitation approach to diabetes as opposed to a traditional clinical model.
One Wirral CIC worked with Graphnet to analyse the waiting lists at Wirral’s Arrowe Park Hospital and identify diabetes patients that were most at risk of having surgery postponed.
Those patients identified were contacted within 48hrs for an appointment with a diabetes prehabilitation health coach. They would then have their haemoglobin A1C (HbA1c) test to measure the average blood sugar level over the past two to three months.
If the results were over 69mmols (an ideal HbA1c level is below 48mmols), they were booked in for an appointment with a diabetes specialist nurse, who looked at medicines management and optimisation as well as personal health.
The service helped reduce HbA1c levels in the 178 patients referred to the service from 73.4 to 63.25 in just 12 weeks. They also saw a reduction in BMI from 34.2 to 32.99.
Lucy Holmes, Wellbeing Lead at One Wirral CIC said: “The population health and data-driven approach means we are able to contact the right people at the right time and give them the best intervention before their procedure.
“It means we’re looking at a person from a holistic point of view, not just clinically and not just non-clinically.”
David Grigsby added: “One enormous step forward has been the digitisation of care plans, including for long-term conditions like diabetes and end of life care. These are held and shared on care records, enabling professionals involved in a patient’s care to see their preferences, important medical notes and agreed approaches.
“Progress is being made. However, we have only just started to scratch the surface.”
A more personalised approach to medicine can also help with risk prevention. A new study on the prescribing of statins to HIV patients found that the bidirectional sharing of medical records between GPs and HIV clinics could help identify those with HIV who cardiovascular risk and provide a more personalised approach to their medication and care. [1]
Personalised medicine statistics
The personalised medicine market is growing fast in a bid to help deliver the so-called ‘four Ps’[2]:
· Prediction and prevention of disease
· Precise diagnoses
· Personalised interventions
· A participatory role for patients
Here are some statistics to show the grow and impact of personalised medicine:
· Global personalised medicine market was worth £446bn in 2023[3].
· Oncology has the largest market share of this market by application with 41.8%[4].
· There are around 400 million people with rare diseases across the world that could be helped by personalised medicine. [5]
· Standard doses of common painkillers don’t work for around 10% of people, suggesting a more personalised approach for even the most basic medicines could have positive impacts. [6]
· Responses to 34 different drugs are impacted by someone’s genetics[7].
Benefits of personalised medicine
Personalised medication is not simply about providing people with the exact type of medication they need – it provides wider benefits to the community and healthcare industry.
· Customising medical treatment: By moving away from a one-size-fits-all approach, medical institutions can customise treatments on a case-by-case basis.
· Diagnostic precision: Healthcare providers are more able to predict the likelihood of developing conditions and offer relevant medical treatments. Direct access to patient dispositions, environments and lifestyles uncovers specified risk factors, leading to better planning.
· Patient participation: Patients have greater control of their treatment by giving them power over aspects of their medical information, including who has access to their records, and restricting certain details from healthcare providers.
· Disease prevention: Personalised medication, when used with SCRs, can be used to predict susceptibility to disease, improve disease detection and pre-empt disease progression using customised disease-prevention strategies. [8]
Issues with this approach
While personalised medication can be hugely effective, there are some areas that need to be considered and addressed as this approach develops:
· Biased data. Studies show people from disadvantaged backgrounds are more reluctant to share health data, meaning some shared care records might miss them or not be balanced. [9]
· Legal issues. Worries around confidentiality and data security could hamper its growth with many people still not willing to share their data because of these concerns.
· Training. A lack of training among doctors to provide a personalised medicine approach could hamper its growth, especially when dealing with genetic data. Demand for ‘genetic counsellors’ is soaring in the US, with the field predicted to grow by 27% by 2028[10].
· Incomplete records. Even with the massive strides in shared care records, some NHS trusts don’t have the depth of information that others do, leading to an imbalanced regional approach[11].
The rise in shared care records
SCRs are starting to minimise health inequalities, reduce hospital admissions and improve patient engagement. But they can also be used to dispense personalised medicine more effectively. SCRs use a number of data points to help find those who could benefit from such an approach to medication.
SCR data may include:
· Address and contact numbers
· Patient medications (previous and current)
· Test results
· Care plans
· Appointments
· Inpatient stays
· Medical decisions
· Discharge information
· Allergies
· Other relevant information
By consolidating patient healthcare data, healthcare providers can make informed decisions about how to treat their patients before they walk in, including what medications to prescribe.
Graphnet’s Shared Care Record Solution
Graphnet has been working for 30+ years on a fully integrated shared care records solution. This solution has – so far – been adopted by NHS trusts, councils and health care providers across the UK.
The Graphnet solution includes records for over 20 million individuals – making it one of the leading and most detailed shared care record solutions in the country.
The platform connects with all major health and social care IT systems in the UK. API portals are also available for third-party applications.
Not only does this solution provide millions of data points, it’s also cloud-hosted to ensure scalability, resilience, and security.
The Graphnet Shared Care Record can also be integrated with Graphnet’s population health platform. This uses the rich data held in the shared care record to produce in-depth insights, targeted actions and analysis at the population, cohort, or individual level.
Contact Graphnet Health to create your Shared Care Record and receive faster, better, and more joined up future care.
