Individualised medicine from the perspectives of patients using complementarytherapies: a meta-ethnography approach

• Published in: BMC complementary and alternative medicine 2013-06, Vol.13 (1), Article 124
• Main Authors: Franzel, Brigitte, Schwiegershausen, Martina, Heusser, Peter, Berger, Bettina
• Format: Article
• Language: English
• Subjects: Alternative medicine; Care and treatment; Health behavior; Medical research; Medicine, Experimental; Methods; Patients
• ISSN: 1472-6882; 1472-6882
• DOI: 10.1186/1472-6882-13-124

Background Personalised (or individualised) medicine in the days of genetic researchrefers to molecular biologic specifications in individuals and not to aresponse to individual patient needs in the sense of person-centredmedicine. Studies suggest that patients often wish for authenticallyperson-centred care and personal physician-patient interactions, and thatthey therefore choose Complementary and Alternative medicine (CAM) as apossibility to complement standard care and ensure a patient-centredapproach. Therefore, to build on the findings documented in thesequalitative studies, we investigated the various concepts of individualisedmedicine inherent in patients' reasons for using CAM. Methods We used the technique of meta-ethnography, following a three-stage approach:(1) A comprehensive systematic literature search of 67 electronic databasesand appraisal of eligible qualitative studies related to patients'reasons for seeking CAM was carried out. Eligibility for inclusion wasdetermined using defined criteria. (2) A meta-ethnographic study wasconducted according to Noblit and Hare's method for translating key themesin patients' reasons for using CAM. (3) A line-of-argument approachwas used to synthesize and interpret key concepts associated withpatients' reasoning regarding individualized medicine. Results (1) Of a total of 9,578 citations screened, 38 studies were appraised with aquality assessment checklist and a total of 30 publications were included inthe study. (2) Reasons for CAM use evolved following a reciprocaltranslation. (3) The line-of-argument interpretations of patients'concepts of individualised medicine that emerged based on the findings ofour multidisciplinary research team were "personal growth","holism", "alliance", "integrativecare", "self-activation" and "wellbeing". Conclusions The results of this meta-ethnographic study demonstrate that patients'notions of individualised medicine differ from the current idea ofpersonalised genetic medicine. Our study shows that the"personal" patients' needs are not identified with aspecific high-risk group or with a unique genetic profile in the sense ofgenome-based "personalised" or "individualised"medicine. Thus, the concept of individualised medicine should include thehumanistic approach of individualisation as expressed in concepts such as"personal growth", "holistic" or "integrativecare", doctor-patient "alliance","self-activation" and "wellbeing" needs. This shouldalso be considered in research