PRECISION MEDICINE SHOULD BECOME NORMAL TO IMPLEMENT IN PRIMARY CARE PRACTICE

Isa Houwink is a GP in Maastricht where she began practicing in 2008. She is also Assistant Professor in Pharmacogenetics in Primary Care at the Leiden University Medical Centre where she teaches GPs to incorporate pharmacogenetics and genetics into their daily practice.

Here, she speaks to PMF Editor Mark Glover about genetic education for family doctors and how it should not be perceived as something special or different.

How are GPs currently using pharmacogenetic information in their practice?

Just this morning, I was teaching some GP trainers here in Leiden about using genetics and pharmacogenetics in their practice, many were saying that they are already applying genetics into their data care, however when we actually looked into how often they implement it into their daily practice it wasn’t that often at all. They are, very interested in pharmacogenetic profiles, as they are profiles that they can really use but taking and drawing information from a family history is something they think they were doing but actually they were not when we and others looked into this previously.

How should precision medicine be viewed by GPs?

When I started my PHD in 2009 I looked into genetic education needs including the use of family history information and other applications of pharmacogenetics in daily primary care. I don’t think doing this should be seen as something that is special or different. It’s very normal, it might be a new term but it should become a normal thing for us to implement.

As family practitioners we actually see healthy people who have to deal with risk factors such as genetics and pharmacogenetics risk factors and environmental factors. It should just be another thing to deal with, another risk factor to take into account just like smoking or age or high cholesterol. I like to compare it to another piece of the puzzle.

When I educate GPs about precision medicine I try to explain that prevention is better than cure. Especially in primary care, where we prevent diseases and we keep people healthy as much and as long as possible. Using genetics and pharmacogenetics to do this is another step we should be doing. So, it’s not so much about primary prevention, it’s more about secondary prevention where you have to take into account previously mentioned risk factors. When you look at a patient who is in front of you, it’s not about applying the guidelines that we use for the whole practice population, but applying the guidelines to the individual who is in front of you.

What inspires you?

Of course, it is helping people, but really when I started my research in the United States, more than 20 years ago now, I looked into small mistakes in a gene that causes the rare disease Rett Syndrome. Very small mistakes in that gene can cause such terrible neurological problems, not just for the patient themselves but also for their families. As family doctors, it’s really about being there and being as supportive as possible also when it comes to (pharmaco)genetics. This is what inspires me.

Isa Houwink will be speaking at the Benelux Precision Medicine Forum in Utrecht which takes place from 12 to 13 June. You can register for the event here.