The state-of-the-art and barriers for the adoption of personalised prevention in Europe and beyond

Abstract

Abstract Personalized prevention is a priority of the European Commission’s research agenda, exemplified by the EU-funded project ‘a PeRsonalised Prevention roadmap for the future HEalThcare’ (PROPHET), a coordination and support action of the International Consortium for Personalized Medicine. It aims to bolster health systems in implementing innovative, sustainable, and high-quality personalized strategies to prevent chronic diseases. In this context, a scoping review was conducted to map personalized preventive approaches (PPA) for chronic diseases and obstacles to their adoption worldwide. The review followed the Arksey-O’Malley guidelines and was conducted from January 2017 to December 2023, on PubMed, Web of Science, Scopus, and grey literature. Eligible studies were primary reports and guidelines, while for the barriers to their adoption we included literature reviews. We included 120 documents on approaches and 34 reviews on barriers. Among the former, 251 PPA were identified: 69% on cancer, 21% on cardiovascular diseases, and 10% on neurological, psychiatric, and metabolic diseases. Furthermore, 27% were on primary prevention, using omic biomarkers to predict disease risk and guide preventive strategies; 27% on secondary prevention, using genomics to guide screening programs; 46% on tertiary prevention, using pharmacogenomics or targeted therapies to prevent disease complications. Among the 34 reviews on barriers, the majority were about the lack of clinical utility evidence and research needs, ethical and legal issues, and limited knowledge among health professionals, citizens, and patients. The majority of the barriers (76%) were referred to primary and secondary prevention, consistent with the low rates of existing approaches in these areas. Ongoing efforts show promise for tailoring prevention strategies, but further research and integration are needed to maximize their potential in improving population health and reducing chronic disease burdens on health systems.