System Medicine Approaches for the Definition of Complex Phenotypes in Chronic Diseases and Ageing. From Concept to Implementation and Policies
Jean Bousquet, Christian Jorgensen, Michel Dauzat, Alfredo Cesario, Thierry Camuzat, Rodolphe Bourret, Nicolas Best, Josep M Anto, Frederic Abecassis, Pierre Aubas, Antoine Avignon, Melanie Badin, Hubert Blain, Arnaud Bourdin, Jacques Bringer, William Camu, Guilhaume Cayla, David J Costa, Philippe Courtet, Jean Paul Cristol, Pascal Demoly, Jean Emmanuel de la Coussaye, Pierre Fesler, Fares Gouzi, Jean Christophe Gris, Bernard Guillot, Maurice Hayot, Claude Jeandel, Olivier Jonquet, Laurent Journot, Gwenanelle Mathieu, Jacques Morel, Gregory Ninot, Jean Yvon Pelissier, Marie Christine Picot, Françoise Rabier-Pontal, Jean Marie Robine, Michel Rodier, Ariane Sultan, Anne Wojtusciszyn, Charles Auffray, Rudi Balling, Cristina Barbara, Anne Cambon-Thomsen, Niels H Chavannes, Alexander Chuchalin, George Crooks, Antoni Dedeu, Leonardo M Fabbri, Judith Garcia-Aymeric, Jawad Hassan, Elisabete Melo Gomes, Susana Palkonen, François Piette, Christophe Pison, David Price, Boleslaw Samolinski, Holger J Schunemann, Peter J Sterk, Panayitakis Yiallouros, Josep Roca, Philippe Vande Perre and Jacques Mercier
Chronic diseases are diseases of long duration and slow progression. Major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, rheumatologic diseases and mental health) represent the predominant health problem of the Century. The prevention and control of NCDs is the priority of the World Health Organization 2008 Action Plan, the United Nations 2010 Resolution and the European Union 2010 Council. The novel trend for the management of NCDs is evolving towards integrative, holistic approaches. NCDs are intertwined with ageing. The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has prioritised NCDs. To tackle them in their totality in order to reduce their burden and societal impact, it is proposed that NCDs could be considered as a single expression of disease with different risk factors and entities.
An innovative integrated health system built around systems medicine and strategic partnerships is proposed to combat NCDs. It includes (i) understanding the social, economic, environmental, genetic determinants, molecular and cellular mechanisms underlying NCDs; (ii) primary care and practice-based interprofessional collaboration; (iii) carefully phenotyped patients; (iv) development of unbiased and accurate biomarkers for co-morbidities, severity and follow up of patients; (v) socio-economic science; (vi) development of guidelines; (vii) training; and (viii) policy decisions. The results could be applicable to all countries and adapted to local needs, economy and health systems.
This paper reviews the complexity of NCDs intertwined with ageing. It gives an overview of the problem and proposes two practical examples of system medicine applied (MeDALL) to NCD co-morbidities (MACVIA-LR)
Chronic disease, co-morbidities, health system, systems medicine, patient, active and healthy ageing, MeDALL, MACVIA-LR
University of Montpellier 1, Centre Hospitalier Régional Universitaire, Montpellier France