Title : Towards Personalized & Precision Medicine (PPM): Personalized health-related and integra-tive nursing care in precision medicine era

The implementation of Personalized and Precision Healthcare Services requires major health systems changes, including the incorporation of information technology to handle the data and introduce support tools for clinical use of the information. However, it also brings important implications for nursing to the forefront as nurses must have adequate preparation and knowledge of the ongoing evidence to care for patients using PPM-based strategies. As patient advocates, educators, and providers of direct care, nurses will be on the front lines of implementation of state of the science care. In this context, nurses need to be prepared to assist patients in interpreting the results of consumer-based testing, and/or referring to the targeted specialists as needed. Nurses need to assess clinical risk factors; discuss and clarify patient values and priorities; provide information to enhance decision making around screenings or risk-reducing treatments; and provide support for family notification and testing as indicated.

Nurses need to be at the forefront of patient care with a multidisciplinary team to truly deliver PPM-based care. Nurses need to be prepared to assist patients in interpreting the results of clinical genetic testing, as well as commercially available consumer-based testing, and/or referring to genetic specialists as needed. It is likely that these activities will be in concert with a genetic counselor; however, nurses are anticipated to fill the increasing gap in services related to genetic counseling that are consistent with the scope of nursing practice. Nurses need to assess other clinical risk factors; discuss and clarify patient values and priorities; provide information to enhance decision making around screenings or risk-reducing treatments; and provide support for family notification and testing as indicated.

For nursing services of the near future to come, the main challenge is the incorporation of the OMICS-technologies in training and professional practice, so that nurses can empower themselves to provide personalized care to individuals and families based on PPM-driven innovations. For instance, the implications in global PPM and in personalized and precision cancer nursing care include interpretation and clinical use of novel and personalized information including genetic testing; patient advocacy and support throughout testing, anticipation of results and treatment; ongoing chronic monitoring; and support for patient decision-making. Attention must also be given to the family and ethical implications of a personalized approach to care. In particular, cancer nurses are important touchpoints in contact and communication with patients, since nurses complete comprehensive assessments, examine a patient’s lifestyle, assess symptoms.

To meet the new demands for care, these advances need to be incorporated into professional nursing practice and, above all, into nursing care. In order for patients and their families to fully benefit from the explosion of genomic knowledge, healthcare professionals, especially nurses, need to grasp the underlying principles of genomics that have been shaping all healthcare practice and care. Therefore, the necessary emphasis on the professional training of nurses based on genomics will become an important requirement as the omics sciences will become part of routine care, no longer being exclusively an area of specialization.

Nurses face increasing challenges and opportunities in communication, support, and advocacy for patients given the availability of advanced testing, care and treatment in PPM. Meanwhile, the current curricula for training nurses often fail to give them the knowledge they need to deliver precision care and thus do need to understand PPM in some depth. And a lack of medical guidelines has been identified by responders as the predominant barrier for adoption, indicating a need for the development of best nursing practices! So, nursing education and continuing education, clinical decision support, and health systems changes will be necessary to provide personalized multidisciplinary care to patients, in which nurses play a key role. And getting education and collaboration right for PPM-driven resources could be just a first step towards a more universal involvement of nurses in precision health! Meanwhile, a lack of medical guidelines has been identified by responders as the predominant barrier for adoption, indicating a need for the development of best nursing practices and guidelines to support the implementation of PPM! This is the reason for developing global scientific, clinical, social, and educational projects in the area of PPM to elicit the content of the new branch. So, nursing education and continuing education, clinical decision support, and health systems changes will be necessary to provide personalized multidisciplinary care to patients, in which nurses play a key role.

Sergey Suchkov was born in the City of Astrakhan, Russia, in a family of dynasty medical doctors. In 1980, graduated from Astrakhan State Medical University and was awarded with MD. In 1985, Suchkov maintained his PhD as a PhD student of the I.M. Sechenov Moscow Medical Academy and Institute of Medical Enzymology. In 2001, Suchkov maintained his Doctor Degree at the National Institute of Immunology, Russia. From 1989 through 1995, Dr Suchkov was being a Head of the Lab of Clinical Immunology, Helmholtz Eye Research Institute in Moscow. From 1995 through 2004 - a Chair of the Dept for Clinical Immunology, Moscow Clinical Research Institute (MONIKI). In 1993-1996, Dr Suchkov was a Secretary-in-Chief of the Editorial Board, Biomedical Science, an international journal published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK.