Precision Health: Treat and Manage Disease

What to know

Your genes, behaviors (such as exercise and eating habits), and environment are all factors that affect your health. The goal of precision health is to protect your health by measuring these factors and acting on them. Plans to treat and manage your disease can be tailored to you, rather than using the same approach for everyone. Precision health approaches can be used for treatment and management of diseases.

A figure and a double helix. Genetic engineering concept. DNA. Gene therapy.

What it is

You might have heard the terms "precision medicine" and "precision health" and wondered how they relate to you. Precision medicine, also called personalized medicine, helps your healthcare provider find your unique disease risks and treatments that will work best for you. Precision health is broader—it includes precision medicine but also includes approaches that occur outside the setting of a healthcare provider's office or hospital, such as disease prevention and health promotion activities. Precision health involves steps that everyone can take on their own to protect their health as well as steps that public health professionals can take (sometimes called precision public health).

How it works

Let's explore how precision health approaches can improve treatment and management of diseases.

Biomarker testing can help your healthcare provider choose the best treatment: Biomarker testing (also called tumor profiling or tumor genetic testing) looks at genetic or other changes in solid tumors and blood cancers. Finding these changes can help healthcare providers choose a treatment that's most likely to work. Even if two people have the same type of cancer, they may need different treatments. Biomarker testing can also predict if the cancer is more likely to return, which can help people decide whether to have treatments, such as chemotherapy or radiation.

EXAMPLE: Tiffany has breast cancer for the second time. Biomarker testing shows she has triple-negative breast cancer. She decides to have more aggressive treatment this time, including a mastectomy (removing the entire breast and all breast tissue), radiation, and chemotherapy.

Pharmacogenomics can help your healthcare provider prescribe the drug and dose most likely to work for you: How you respond to a drug is the result of many factors, including your genes. Some people may benefit from a drug, while others may respond poorly or have serious side effects. Pharmacogenomics looks at how your genes affect the way you respond to drugs and can help your healthcare provider choose a drug and dose that is most likely to be safe and effective for you.

EXAMPLE: Alyssa has Tourette syndrome. Before prescribing the drug pimozide to treat the condition, Alyssa's healthcare provider orders genetic testing for the gene CYP2D6, which affects how her body breaks down pimozide. The genetic testing shows that Alyssa has a version of CYP2D6 that breaks down pimozide slowly. Thus, her healthcare provider knows to treat Alyssa with a lower dose.

Continuous glucose monitoring systems can improve insulin dosing: Regular monitoring of blood sugar is key to managing diabetes with insulin. Continuous glucose monitoring systems use sensors on the arm or belly to constantly monitor blood sugar. Their use can improve insulin dosing, prevent complications, and allow users to share results with their healthcare providers.

EXAMPLE: Anthony's type 1 diabetes isn't under control. He doesn't check his blood sugar levels regularly with his fingerstick device, and finding the right insulin dose for him has been challenging. His healthcare provider recommends using an arm sensor to measure his blood sugar. Using information from the monitor helps his healthcare provider find the right insulin dose and helps Anthony see how his blood sugar levels change in response to what he eats and how active he is. After a few weeks, Anthony's blood sugar levels have stabilized, and his diabetes is well managed.

Mobile devices can support healthy living and improve chronic disease: Personal mobile devices can monitor behaviors, such as your activity, diet, and sleeping habits. They can also help remind you to take medicine, practice mindfulness, and attend regular checkups and cancer screenings.

EXAMPLE: Juan has poorly managed heart disease and diabetes. He tells his healthcare provider he doesn't always remember to take his pills and isn't keeping up with a healthy lifestyle. His healthcare provider recommends that he try using smartphone applications as a daily reminder to take his pills, eat healthier, and exercise. Since doing so, Juan's blood pressure levels are in a healthy range, and he has lost weight.

What you can do

To fulfill the promise of precision health, much more research is needed. The All of Us Research Program, led by the National Institutes of Health, has begun enrolling participants and plans to enroll one million or more U.S. participants. All of Us participants will be followed for several years They answer surveys on different topics and share their electronic health records. Participants may provide blood, urine, or saliva (spit) samples for lab and DNA tests. All health information is stored in a secure database.

All of Us researchers are using this information to look at how genetic, behavioral, and environmental factors can affect health, including likelihood of getting certain diseases and effectiveness of interventions. Having a wide variety of participants for this study is important to make sure it benefits everyone—learn more.