Press release No 23/2024 - The ageing of the population leads to an increased number of patients with multiple chronic diseases and consequently of those subject to multiple prescriptions. Indeed, almost one in three elderly persons (28.5% of the over-65s according to the latest OsMed report) takes 10 or more medicines during the year, at least five in 68% of cases. ‘Many treatments, however, result in low adherence and persistence to therapies, damaging patients' health and wasting resources. These damages are then exacerbated by the fact that the interaction of so many medicines becomes difficult for doctors to keep under control and can generate adverse effects or poor treatment tolerability'. This is how AIFA President Robert Nisticò opened the proceedings of the ‘Working Group on Precision Medicine and Prescriptomics’. ‘Terms with which we will have to become familiar in the era of pharmacogenetics and Artificial Intelligence, which promise to increasingly personalise and optimise therapies’ the AIFA President explained.

In addition to the Agency's experts, the Working Group is also attended by scientific Societies, organisations of health professionals and academics in the field, who are already organised into working groups that should lead to an event where the results of the research activity will be published within a year. ‘Among the goals, not least that of activating all communication channels, including social networks, in order to share with the general population simple and precise information on the correct use of medicines and their possible interactions,’ Nisticò pointed out.

The aims of the Working Group are:

• to draw up guidelines, within the Agency's institutional remit, for the application of precision medicine in the management of pharmacological therapy, with particular emphasis on polypharmacy, and to identify possible precision medicine approaches in the context of good prescribing practices;
• define areas of study, innovative and validated approaches to improve the quality of medicines prescription also on the basis of biochemical-functional information derived from the analysis of an individual's germline genetic inheritance;
• draw up a final report with the aim of adequately informing all stakeholders of the results achieved.

All this with the ultimate aim of improving both length and quality of life of patients on the one hand, while optimising resources on the other. ‘Several studies - Nisticò explained - have shown that using AI to monitor therapies, to send personalised reminders and to provide real-time support can increase adherence to therapies by up to 20%. This translates into a 40% improvement in quality of life and 20% improvement in survival’. Moreover, considering that the cost of non-adherence to treatment is around EUR 2 billion per year for the National Health Service, an increase in adherence of even 15% could reduce welfare costs by EUR 300 million, without taking into account the social costs, e.g. resulting from lost working days.

In addition to AI, an important contribution to the good use of medicines may come from pharmacogenetics, which makes it possible to identify how a patient will metabolise specific medicines. ‘In poly-treated patients - Nisticò added - genomic information also makes it possible to assess medicines interactions and the cumulative impact of therapy, adapting prescriptions to avoid overdoses or therapeutic ineffectiveness due to individual variations in metabolism. And this - he concluded - means being able to reduce side effects, such as the risks of toxicity, and to increase adherence to treatment, meanwhile reducing healthcare costs induced by outpatient visits and hospitalisations, which are caused by adverse drug reactions between 3 and 7 per cent of cases according to US studies.’