APH Developing a research agenda on primary health care with the 7K Medicine approach
Chronic diseases are responsible for the highest burden of disease in high-, middle- and low-income countries, taking a huge financial and social toll. Healthy living is the main way of preventing the progression towards and development of chronic diseases. Despite all stakeholders recognizing the importance of prevention, few programs that successfully address the burden of chronic diseases have been developed and scaled-up. We believe that innovative solutions targeting individuals with personalized health promotion and prevention services in primary care are crucial. Behavior change then goes beyond providing personalized health information as being supported by other health promotion strategies. By complementing population-based approaches, primary care services could hence play a much more prominent role in health promotion and prevention of chronic diseases.
A potential solution is the ‘7K Medicine’ approach developed by Gentest Institute in Istanbul (Turkey). This is an innovative approach to the prevention of chronic diseases. The title, 7K, refers to personalized, predictive, preventive, comprehensive, precise, evidence-based and participatory medicine (words that all begin with ‘K’ in Turkish). In Turkey, since 2006, personalized health care based on 7K Medicine has been delivered to people who would like to learn how to manage their health and have been willing to pay for it. This model utilizes an individual’s personal health information, family history, lifestyle factors, various biomarkers and genotype to prevent, detect early and stop/slow down the progression of chronic complex diseases in a targeted way with personalized lifestyle and medical follow-up plans. Application of 7K model as Gentest was identified as a ‘best practice model’ by Public Health Genomics European Network in 2008. It has been successfully delivered to more than 2,000 individuals who, as part of the program, provided comprehensive lifestyle and health data.
7K Medicine in Turkey is a promising innovation for the prevention of chronic diseases on an individual level and can be considered as a ‘niche experiment’ that became viable in its local context. There are opportunities to transform the model into a publicly available tool for the management of the health of populations. Furthermore, it could be used to encourage health systems to assume greater responsibility for the prevention of chronic diseases. To achieve its potential, there is a need to investigate whether and how the 7K Medicine model can be transformed and adapted for wider application in primary care services and how health systems can integrate such a preventive primary health care application. This project aims to work on development of a research agenda to identify issues that need to be studied to facilitate the transformation of 7K Medicine into a publicly available tool for population health management to prevent chronic diseases. As a first step, a realist evaluation approach will be applied to the current practice of 7K Medicine in Istanbul, Turkey, to investigate how the practice model as a whole and its components work, for whom and under which conditions.
This project received a seed fund from the Amsterdam Public Health’s APH Global Health Program – Promotion of Collaboration 2019 and is a collaboration of Athena Institute (VU Amsterdam); department of Public Health at Amsterdam UMC, location AMC; Amsterdam Institute for Global Health and Development (AIGHD); and Gentest Institute. The project’s core team is represented by these institutes: Dr. Tomris Cesuroglu (Athena Institute, VU), Dr. Elena Syurina (Athena Institute, VU), Prof. Karien Stronks (dept. Public Health, AMC), Dr. Christopher Pell (AIGHD), and Dr. Serdar Savas (Gentest Institute).