Exploring interdisciplinary perspectives on the implementation of personalized medicine and patient-orchestrated care in Alzheimer's disease: A qualitative study within the ABOARD research project

TL;DR

This study explores how healthcare professionals interpret personalized medicine and patient-orchestrated care in Alzheimer's disease, highlighting differences in views and implementation challenges.

Contribution

The study provides new insights into interdisciplinary perspectives on personalized medicine and patient-orchestrated care in Alzheimer's disease.

Findings

Professionals view personalized medicine as involving biomedical and psychosocial factors, while patient-orchestrated care relates to decision-making.

Differences exist in views on patient-orchestrated care regarding desirability and feasibility.

Implementation challenges persist, with no thematic differences between clinicians and other professionals.

Abstract

The concepts of ‘personalized medicine’ and ‘patient-orchestrated care’ in Alzheimer's disease (AD) lack standard conceptualization, which presents challenges for collaborative and interdisciplinary care.

We explored the interpretations and perspectives of professionals involved in interdisciplinary work on a large-scale project, “ABOARD”, with the aim to implement personalized medicine and patient-orchestrated care in AD.

Semi-structured interviews were conducted with 30 professionals and audio-recorded. Two researchers independently coded the data inductively, followed by a thematic analysis.

According to professionals across different disciplinary backgrounds (mean age 45.7 years; 53.3% female), personalized medicine pertains to the relevant options that an individual has, informed by biomedical and psychosocial factors, whereas patient-orchestrated care captures factors relevant to the decision-making process. Professionals differed in their views on patient-orchestrated care regarding its desirability and feasibility. The concepts were viewed as similar by professionals, as both involve personal preferences while ultimately assigning responsibility to the clinician. However, implementation challenges persist, and no thematic differences were found between clinicians and other AD-related professionals.

AD professionals have shared interpretations and perspectives on implementation of personalized medicine but differed in their views on patient-orchestrated care. Personal preferences are seen as part of personalized medicine, but not yet reflected in definitions in the AD field and beyond. Critical discussions on the challenges and existing doubts are necessary for both personalized medicine and patient-orchestrated care. Multi-level implementation changes are needed for both concepts, which warrants stakeholder involvement as well as support and resources from the entire AD field.

Figures