par Kholmanskikh, Olga 
Président du jury Van Wilder, Philippe
Promoteur Martini, Jessica
Publication Non publié, 2021-08-02
Président du jury Van Wilder, Philippe
Promoteur Martini, Jessica
Publication Non publié, 2021-08-02
Mémoire
| Résumé : | Background: The concept of ‘personalised or precision dosing’ has a potential to improve the impact of medicinal products exposure on clinical outcomes, to contribute to person/patient centredness approach and to promote cost saving practices. However, the definition of this concept, its relation to ‘personalised medicine’ and its potential implementation within person-centred health systems are not clear yet.Objectives: The main objective of the scoping review is to explore how can personalised dosing of medicinal products fit into or integrate a person-centred health system. Three specific questions are pursued: (1) How is the concept of “personalised/precision dosing” defined in the scientific literature? (2) To which population(s) exposed to particular medicinal products this concept is applicable? (3) What is the context for implementation processes?Design: This review follows Johanna Briggs Institute methodology for scoping reviews applying the modified methodological framework outlined by Arksey and O’Malley. The search strategy included eight databases for peer-reviewed publications and dissertations and targeted records with terms “personalised dosing” or “precision dosing” in the title published from January 2015 to May 2021. Records were screened by one reviewer who also extracted results using a predefined charting form. The synthesis of the results to address the third specific question was guided by the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework using categories related to 7 domains of the framework: condition, technology, value proposition, adopter system, health/care organisations(s), wider system, embedding and adaptation over time.Results: The review included 101 selected documents. At first, the results allowed to clarify the concepts of personalised and precision dosing. Second, populations to which this concept is applicable have been determined. Third, the barriers and facilitators to implementation processes, as well as the extent of the complexity by 7 NASSS framework domains were explored. Potential recommendations within each domain were also outlined.Discussion: The literature review carried out clarified the definitions currently employed for the ‘personalised dosing’ concept, which is used interchangeably with the ‘precision dosing’ concept. Considering person/patient involvement within ‘personalised dosing’ is suggested by the author. The current eligibility criteria for ‘personalised dosing’ specific to certain populations exposed to specific medicinal products could be identified. Finally, the NASSS provided a structured approach to identify barriers, facilitators and recommendations for implementation of ‘personalised dosing’ in health systems.Conclusions: This scoping review provides mapping characteristics for the emerging concept of personalised dosing and, by applying the NASSS framework, allows to determine barriers and facilitators to the implementation processes. Further opportunity presents to study and validate this framework in guiding the implementation processes for technologies and tools supporting personalised dosing or other interventions. |
