The P4 health spectrum – a predictive, preventive, personalized and participatory continuum for promoting healthspan

Sagner, Michael, McNeil, Amy, Puska, Pekka, Auffray, Charles, Price, Nathan D., Hood, Leroy, Lavie, Carl J., Han, Ze-Guang, Chen, Zhu, Brahmachari, Samir Kumar, McEwen, Bruce S., Soares, Marcelo B., Balling, Rudi, Epel, Elissa and Arena, Ross (2017) The P4 health spectrum – a predictive, preventive, personalized and participatory continuum for promoting healthspan. Progress in Cardiovascular Diseases, 59 5: 506-521. doi:10.1016/j.pcad.2016.08.002

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Author Sagner, Michael
McNeil, Amy
Puska, Pekka
Auffray, Charles
Price, Nathan D.
Hood, Leroy
Lavie, Carl J.
Han, Ze-Guang
Chen, Zhu
Brahmachari, Samir Kumar
McEwen, Bruce S.
Soares, Marcelo B.
Balling, Rudi
Epel, Elissa
Arena, Ross
Title The P4 health spectrum – a predictive, preventive, personalized and participatory continuum for promoting healthspan
Journal name Progress in Cardiovascular Diseases   Check publisher's open access policy
ISSN 1873-1740
Publication date 2017-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.pcad.2016.08.002
Open Access Status File (Author Post-print)
Volume 59
Issue 5
Start page 506
End page 521
Total pages 16
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Language eng
Abstract Chronic diseases (i.e., noncommunicable diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often ‘silent’ chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as “P4” holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a ‘P4 Health Continuum’ model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.
Keyword Allostasis
Allostatic load
P4 medicine
Systems biology
Systems medicine
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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