An Entry for Personalized Medical Practice in Primary Care

The successful practice of personalized medicine in primary care depends upon understanding a patient’s individual disease risk and anticipating the best course of treatment with the goal of maintaining good health. A personalized disease risk assessment leads to recommendations for evidence-based interventions that can delay/prevent disease onset or reduce the severity of disease. As the sophistication of medical diagnoses develops and new interventions become available, the value of collecting and analyzing family health history (FHH) for maintaining patient wellness by determining ‘the right treatment, at the right time, for the right patient’ is more apparent than ever. FHH remains underutilized in primary care.

however, because of numerous barriers. Ironically, the introduction of genetic tests and genomic methods that identify carriers who might be vulnerable to a variety of medical conditions and diseases has simply raised the importance of collecting and utilizing FHH to guide patient management in primary care.

FHH is perhaps the most cost-effective and robust means to obtain information about a patient’s disease risk. A complete FHH includes the health information of a patient’s blood-related first (parents, siblings, children) and second degree (half-siblings, aunts, uncles, grandparents) relatives over three generations. To be optimally useable for analysis, FHH will denote both affected and unaffected family members, the age of disease onset, disease severity, any recurrences, and cause of death. Even partial FHH information can be useful.

 however, especially if two or more first or second degree relatives are affected from either the maternal or paternal side of a family, since two occurrences of a disease or condition within a lineage usually is sufficient to conclude that an elevated disease risk exists.