Abstract
We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.
Highlights
We propose an innovative, integrated, cost-e ective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century
A proposal for multidisciplinary patient-centered management of chronic NCDs We recommend that, to determine measures of disease severity and control, effective interventions and studies should be built around carefully phenotyped patients (Figure 2) and strictly follow carefully crafted methodological standards
Side effects from treatment multi-scale, multi-level systems approaches. To reduce their socio-economic and public health impacts, we propose that NCDs should be considered as the expression of a continuum or common group of diseases with intertwined gene-environment, socio-economic interactions and co-morbidities that lead to complex phenotypes specific for each individual
Summary
Tobacco use [31], biomass fuel combustion and air pollution [32] are among the major risk factors for NCDs; these act as early as in utero and in early life Those working on the global prevention and control of NCDs should consider these risk factors because translational epidemiology is the key to exploring their role in the development of NCDs and to devising approaches that will enable successful guided interventions [33]. A proposal for multidisciplinary patient-centered management of chronic NCDs We recommend that, to determine measures of disease severity and control, effective interventions and studies should be built around carefully phenotyped patients (Figure 2) and strictly follow carefully crafted methodological standards. We propose that NCD management should move towards holistic multi-modal integrated care, and Assess and regularly review control
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