Personalized medicine and stroke prevention: where are we?

Abstract

There are many recommended pharmacological and non-pharmacological therapies for the prevention of stroke, and an ongoing challenge is to improve their uptake. Personalized medicine is seen as a possible solution to this challenge. Although the use of genetic information to guide health care could be considered as the apex of personalized medicine, genetics is not yet routinely used to guide prevention of stroke. Currently personalized aspects of prevention of stroke include tailoring interventions based on global risk, the utilization of individualized management plans within a model of organized care, and patient education. In this review we discuss the progress made in these aspects of prevention of stroke and present a case study to illustrate the issues faced by health care providers and patients with stroke that could be overcome with a personalized approach to the prevention of stroke.

Keywords:

• stroke
• prevention
• personalized health care
• education

Acknowledgments

The STAND FIRM trial was funded by the NHMRC (586605). Thanks to Sue Mosley and Mary Staios who undertook the education visits for the STAND FIRM trial.

Disclosure

DAC has an unrestricted educational grant from Boehringer Ingelheim for the Victorian Stroke Telemedicine Project and the Australian Stroke Clinical Registry. AGT was supported by NHMRC grant 1042600. DAC was supported by a research fellowship from the NHMRC (1063761) co-funded by National Heart Foundation. MRN has participated in trials that have received funding from SmithKline Beecham, Astra-Zeneca, Bayer, Sanofi-Aventis, Merck Sharp and Dohme, Pfizer, Servier Laboratories, and Bristol-Myers Squibb and has served on advisory boards for Sanofi-Aventis, Novartis, Schering-Plough, Solvay Pharmaceuticals, and AMGEN. He has also prepared educational material for Servier Laboratories, AstraZeneca, Bristol-Myers Squibb, and MediMark and received conference and travel support from Bayer HealthCare AG, Merck Sharp and Dohme, Novartis, and Sanofi-Aventis. CFB has an unrestricted educational grant from Boehringer Ingelheim for the Victorian Stroke Telemedicine Project. The authors have no other conflicts of interest to disclose.