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Overview
Service Benefits
1. Expected Benefits
The overall aim is to improve lifestyle and prevent or delay the onset of common, complex, chronic diseases such as diabetes, cardiovascular disease, osteoporosis, inflammatory disorders (e.g. Arthritis) and cancer. The genetic test is NOT a diagnostic of disease, nor is it a predictor of disease. All of the above mentioned illnesses are caused by a mixture of genetics and lifestyle. A white person will not get skin cancer without exposure to UV rays. An individual with lactose intolerance (due to a genetic variation) will not have gastric problems if he/she avoids dairy products. Similarly, environmental components (the major environmental exposure is diet) are required, as well as a particular genetic background, for the development of the major chronic diseases. So the genetic test itself cannot be predictive since genotype alone is not sufficient to determine whether or not a particular disease will develop. Genetic information can though allow useful advice to be given to help with avoiding the development of disease. Genes cannot be changed but the environment can (especially diet and physical activity) and making changes guided by individual genotype has been demonstrated to lead to improved health benefits (such as reduced levels of LDL cholesterol, homocysteine, blood pressure, DNA damage, a better glucose / insulin balance, etc) which should improve the prospects of avoiding / delaying onset of the diseases related to these components.
The most likely use of the service in Europe will be via healthcare practitioners and the target end users include individuals taking a proactive role in their health, wellness, and disease prevention on one hand and their practitioners on the other.
The benefits of the service include delivery of personalized diet and lifestyle recommendations to individuals in a timely and secure manner with the goal of helping them attain their health and wellness objectives. Compared to the present situation, the service will be greatly improved, with much wider distribution and multilingual solutions to overcome language barriers, and with a decreased price.
The major health problems of the near future will be those of preventable conditions associated with obesity, type-II diabetes and cardiovascular disease. The economic burden on society of these conditions is already being felt and is expected to reach near crisis proportions over the next 10-20 years. To address these coming epidemics healthcare will require a change from curative to preventative and key to this will be fostering changes in lifestyle, principally nutrition and physical activity. A major benefit of the service is that it targets individuals before health conditions materialize and is supported by evidence that personalizing diet and lifestyle through analysis of genetic variation increases motivation and adherence to healthier lifestyles. A further benefit is that in individuals who are already overweight or who suffer from type-II diabetes or cardiovascular disease, diet and physical activity changes can reduce and even reverse symptoms, lessening the need for expensive pharmaceutical interventions and the burden on the medical system & physician time, benefiting both the patient and the physician.
The service will provide practitioners with electronic tools to continually monitor progress of patients, picking up early warning signs and enabling the possibility of effective intervention to improve the patient’s condition. The tools will allow the practitioner to work more efficiently and effectively, saving valuable time and resources. The improved preventive healthcare services will benefit individuals and society as a whole by also reducing absence from work due to poor health
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2. Social and Economic Impact
The EUROGENE project aims to offer the current service at a pan-European level targeting to generate the strongest impact both at social and economic level, eventually encompassing the entire EU27 area. The various possibilities offered nowadays by the new technological advances is easing the offering of EUROGENE like services reinforcing the liaison and coherence of services offered within the various regions and countries of the European Union.
One of the major features to be implemented in EUROGENE is that of multilingualism, in order for the service to generate the best results, also taking in consideration the trans-European perspective of the project. A wide set of services will be provided by EUROGENE able to satisfy each of the needs of the end-users giving as much value add as possible.
The EUROGENE service will be deployed by extending the pilots implemented as part of the Phase A project. As described in the technical annex these services will be localised as required and will involve electronic methods of data delivery. A practitioner portal will be a key part of the service that will be scalable and applicable to clinics throughout Europe. The service will continue to evolve of course from the moment of first deployment, even at the pilot level. Issues will be identified and addressed to continually improve the service itself and its take-up.
Education and communication will be important to achieve success. The majority of healthcare practitioners will be unfamiliar with nutrigenomics and the benefits of nutrigenomics based services. The prevalent mindset among healthcare practitioners, and patients, is one of therapy rather than prevention. The purpose of personal genomics services is prevention, the “patient” will ideally be healthy and will use personal genetic information to make diet & lifestyle adjustments which will help maintain good health and delay the onset of disease. In this respect the practitioner portal will be a conduit for more than just data exchange as it will also provide a platform for dissemination and education. Practitioners will be able to request specific information and clarify issues where needed. It will also be possible to allow practitioners to register for freely accessible areas of the portal even before they actively provide the EUROGENE service – they will be invited to join the portal, study the information, take part in discussions and hopefully move on to become a EUROGENE supplier.
It will also be important to provide information to the consumer and a similar portal type approach may be implemented in a more consumer oriented fashion. Education of the consumer on the benefits of nutrigenomics and preventative healthcare will help to create a consumer demand for the services. Consumers will be encouraged to inform their own practitioners about the services and introduce them to nutrigenomics if they are not already aware.
The nature of the services, using portal and e-communication to engage both practitioners and “patients” will enable a level of continued interaction to be deployed. Keeping both patient and practitioner up to date with advances & new services, and keeping the patient regularly informed of his/her progress by giving access to his/her records has the benefit that it is likely to increase motivation and compliance. The software behind the portal will be written in a way to support integration or exchange of data with patient medical records – standards such as HL7 will be used.
The benefits, both economic and social, are potentially very significant. All of the common complex diseases (cardiovascular, diabetes, cancer, arthritis, osteoporosis, etc) involve genetics and environment and above all are highly preventable with early lifestyle modifications. These are the diseases whose incidence is increasing and which are an ever growing drain on all EU economies through spiralling healthcare costs and work days lost due to poor health. Throughout the EU there are government and health organisation projects to improve lifestyle and to promote preventative healthcare thinking. The EUROGENE service fits very well within these initiatives and will work with them to promote the benefits in the attempt to reverse the current rise towards epidemics proportions of diseases such as diabetes and conditions such as obesity.
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2008