ABSTRACT
PROBLEM IDENTIFICATION: Precision medicine initiatives provide opportunities for optimal targeted therapy in individuals with non-small cell lung cancer. However, there are barriers to these initiatives that reflect social determinants of health. LITERATURE SEARCH: MEDLINE®, CINAHL®, PsycINFO®, Embase®, and Google ScholarTM databases were searched for articles published in English in the United States from 2016 to 2020. DATA EVALUATION: Data that were collected included individual demographic information, specific diagnosis, status of targeted genomic testing, and receipt of targeted therapy. All studies were retrospective and involved database review of insurance claims or medical records. SYNTHESIS: Individuals with non-small cell lung cancer received less genetic testing and targeted therapy if they were of a lower socioeconomic status, had public health insurance or no health insurance, were Black, or lived in rural communities. IMPLICATIONS FOR NURSING: Social determinants of health affect health equity, including in precision medicine initiatives for individuals with lung cancer. Gaining an understanding of this impact is the first step in mitigating inequities.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Health Equity , Lung Neoplasms , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/therapy , Healthcare Disparities , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/genetics , Lung Neoplasms/therapy , Precision Medicine , Retrospective Studies , United StatesABSTRACT
Precision medicine is a new concept that has been routinely encountered in the literature for little more than a decade. With increasing use, it becomes crucial to understand the meaning of this concept as it is applied in various settings. An evolutionary concept analysis was conducted to develop an understanding of the essential features of precision medicine and its use. The analysis led to a comprehensive list of the antecedents, attributes, and consequences of precision medicine in multiple settings. With this understanding, precision medicine becomes part of the broader practice of precision health, an important process proposed by nursing scholars to provide complete, holistic care to our patients. A model for precision health is presented as a framework for care.
