Precision medicine, genomic-driven treatment, phenotyping—it all sounded like too much dense material to cover in one article. But I’m happy to say that the authors of the October CE feature, “Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency,” take this complex content and present it in a clear, straightforward, and interesting way.

‘Omics’ sciences.

We’re delighted to be able to bring you this timely and important content. As the authors explain, advances in the study of genes have given rise to the ‘omics’ sciences—the study of how genes function and how treatments can be tailored to an individual’s genetic makeup, i.e., precision medicine. While we’ve long found ways to tailor care to specific characteristics determined all or in part by genetic differences—–for example, prescription lenses to correct vision, blood typing—the completion of the Human Genome Project has given impetus to using genomics in many areas of care.

The completion of the Human Genome Project . . . provided insight into both mutations (genetic variations that occur in less than 1% of the population) and polymorphisms (genetic variations that are sufficiently common to be considered normal). Genetic variations confer not only such unique individual characteristics as eye color and blood group, but also susceptibility to such diseases as sickle cell and Tay–Sachs as well as response to treatment.

Targeted gene therapies.

While nurses working in oncology—where targeted gene therapies have been used for several years, such as in hereditary breast cancer—may be more familiar with precision medicine, it’s increasingly important that all nurses understand this developing area of knowledge and its implications for care.

For example, we know that patients who by their genetic makeup are “ultrarapid” metabolizers of codeine can experience adverse effects from rapid conversion of codeine to morphine; conversely, patients whose genes make them poor metabolizers may have inadequate or no response to analgesia. (I wonder how many patients who are in this latter category get labeled as “drug-seeking.”)

While most patients won’t have genotyping prior to receiving care, a patient with siblings who’ve had “bad reactions” to certain medications should trigger some thought as to possible genetic influence. Taking an accurate family history is important.

The article is free to read. And you can listen to a podcast with Ruth Lebet and Paule Joseph, two of the authors, about their work.