Personalising diagnosis and treatment options for patients is the next step in respiratory healthcare.

At the British Thoracic Society (BTS) 2023 Winter Meeting, respiratory experts from around the UK are discussing how the future of respiratory medicine could use science and technology to tailor services to unique patient situations and physical constitutions.

Multiple sessions throughout the Winter Meeting highlight personalised care as a topic for discussion. From the advantages and disadvantages of remote consultations, to how an individualised approach to tobacco dependency can improve quit rates in the screening setting, personalised care certainly is touted as already being useful.

Some of the advantages mentioned include greater opportunities for illness prevention, faster and more accurate diagnosis, the opportunity to overcome access barriers to care and improve patient adherence to more effective care. There is also potential for meaningful health system impact including improving quality, reducing the burden on hospital capacity and finances through illness prevention, and more successfully integrating the multi-disciplinary team - improving the day-to-day of the health workforce. Reservations, however, encompass the risk of error, patient confidentiality, access inequalities and the potential time-consuming and costly nature of personalisation.

Both guest lecturers at the Winter Meeting this year elaborate on the idea that through the scientific and technological developments we are seeing in health, there is the chance to help the health system to work smarter, not harder. Professor Helen Reddel yesterday discussed population health and precision medicine, and whether both can be achieved.

On this, Professor Helen Reddel says,

“A radical change is needed in our current siloed disease-based approach to patients presenting with respiratory symptoms, particularly those in low-resource countries which bear the large burden of chronic respiratory and cardiovascular disease. The use of new, scalable precision diagnostic tools will allow targeting of feasible interventions, in order to improve global lung health and better meet the needs of individual patients.”

Today, Sir Martin Landray speaks about improving clinical trials, and how we can continue to develop new treatments for common conditions to better suit the ranging and specific needs of patients. As the volume of complex conditions and co-morbidities increase in our patient population, we will be required to invest in mitigating the notion that there is a one-size-fits-all solution to care.

Sir Martin Landray elaborates,

“Clinical trials lie at the heart of evidence-based medicine. Yet over the past few decades, the burden, cost and complexity have rocketed. As a consequence, many potential treatments are not widely used, many ineffective or even harmful treatments continue to be used, and many advances in drug discovery fail to have the impact they could or are simply not developed at all. During the worst of the COVID-19 pandemic, the RECOVERY trial showed us that there are ways to conduct trials even in the most difficult of circumstances. It showed that some drugs that many were clamoring for were useless whilst others which some thought might be dangerous turned out to save many, many lives. Now is the time to learn from that experience and embark on trials that tackle the huge burden of respiratory and other common diseases. In the words of Dr Rob Califf, FDA Commissioner, ‘Streamlining and quality are not opposed.’ We must not lose sight of that.”

Getting the right care, at the right time, to the right patients remains a united goal of respiratory experts across the UK. Achieving this through developments in personalised healthcare, precision medicine, and therapies resultant from smart clinical trials seems to certainly be an option as we move into the future of preventing and treating respiratory illnesses.

Chair of the BTS Science and Research Committee, Professor James Chalmers, affirms,

“The BTS winter meeting showcases the best of today’s respiratory medicine and science, but more than that it should show us where science needs to go in the future to maximise benefit for our patients. Our two outstanding keynote lectures this year show us that the future is precision medicine: firstly, in clinical practice and global health and secondly in the conduct of more streamlined large scale clinical trials. The future for lung health is bright if we can embrace some of the lessons of the COVID-19 pandemic and develop pragmatic, precision guided practice.”