Barriers and facilitators to the implementation of personalised medicine at the micro-, meso- and macro-regional levels

Abstract Background/Introduction Personalised Medicine (PM) involves tailoring treatment to a patient's characteristics, needs and preferences. It classifies patients based on their disease risk or response to treatment using diagnostic markers and aims to improve treatment control, precision and disease prediction. An organised approach is crucial for the integration of PM into European healthcare systems in order to shape the future of health and social care. PM's dynamic evolution, which takes into account individual factors in disease progression and drug efficacy, allows for more accurate and tailored care. Despite its emergence, the economic focus on specific interventions has neglected a comprehensive theoretical framework, potentially hindering the progress of PM in clinical practise. 1 Purpose The purpose of the study was to identify barriers and facilitators to the implementation of innovative interventions and to identify best practises that are applicable across European countries and support the implementation of e-health, m-health and PM interventions at micro-, meso- and macro-regional levels. The research was funded and carried out as part of the international Regions4PerMed (H2020) project. Methods The methodology of the study consisted of a combination of desk research and qualitative research methods. Desk research involved analysing existing articles, with a focus on the literature related to barriers and facilitators in e-health and m-health. Following the desk research, a semi-structured questionnaire entitled "Barriers and facilitators of Personalised Medicine implementation - qualitative study under Regions4PerMed (H2020) project" was developed. In addition, three focus groups were organised to explore the topic of the study in greater depth. Results The findings on potential support for adapting e-health, m-health and PM to citizens' needs were categorised into different areas of need, including education, funding, dissemination, data protection/data sharing, data analysis, system changes, integrated care policies, cooperation, healthcare providers, physicians, public and patient engagement. The barriers and facilitators were categorised according to the primary stakeholders involved in the implementation challenges. Conclusion(s) The implementation of technological solutions improves diagnostic procedures and decision making in health and social care, leading to more precisely tailored treatments, lower costs and shorter treatment durations. PM plays a crucial role in rationalising the diagnosis, prevention and treatment of diseases. The overall aim is to break down barriers between healthcare providers such as public authorities and hospitals in order to promote closer collaboration. However, PM faces challenges, including incongruent legislation, bureaucratic procedures and lengthy legislative processes. Obstacles also include the approach to physician education and the lack of social awareness of PM.