As the PROPHET project comes to a close, PHG Foundation has led on a policy briefing which outlines the key recommendations for EU and national governments to implement personalised prevention programmes.
PROPHET (A PeRsOnalized Prevention roadmap for the future HEalThcare) is a consortium of 18 organisations from countries across Europe working to build a roadmap for future healthcare, focusing on the use of personalised prevention. At a recent meeting in Brussels, the consortium met in person for the final time to reflect on and discuss the project’s findings and key next steps, as outlined in the briefing.
PROPHET has gathered a wealth of information on evidence in personalised prevention and on strategies that could support implementation into healthcare systems. The challenge of ageing populations and increase in non-communicable diseases is well known, however a key question that arises is how we can support policy makers at the EU and national levels to turn ideas in personalised prevention into practical solutions. In the briefing, we describe priorities for implementing personalised prevention in Europe, providing a focus for policy makers on key areas, and links to further information via the project’s toolbox.
Four priorities: evidence, data, empowerment and equity
The briefing focuses on four key areas for action, bringing together the highlights of the project’s findings:
- Establish evidence and assessment strategies for integration of personalised prevention in routine care, across the entire healthcare system
- Build and regulate interoperable and trusted data infrastructure, which meets appropriate ethical and legal safeguards
- Empower and engage citizens, professionals and policy makers, through education, training and citizen engagement
- Embed equitable and ethical healthcare access and citizen trust, including support for vulnerable and underserved populations.
One element that we were keen to highlight in the briefing is the opportunity to build on existing initiatives, rather than trying to reinvent the wheel in terms of healthcare prevention. PROPHET exists in a thriving ecosystem of EU-funded initiatives and building on these should reduce repeated effort. Significant investment has already been made in data infrastructures, for example the European Health Data Space. Existing initiatives, such as the Safe Hearts Plan, the Beating Cancer Plan, and the Healthier Together Initiative share aims and objectives with PROPHET in terms of preventing disease and promoting better health.
The discussions at the conference brought into focus three challenges that I think are particularly relevant, not just for the personalised prevention agenda, but how research findings more generally makes their way into real world clinical practice.
Evidence: Our work on preventive biomarkers showed that there is a big gap between the evidence generated in research, and evidence for clinical utility of those biomarkers. As we highlighted, there is a need to consider how evidence that would support demonstration of clinical utility is collected during the research process. One challenge is that this evidence, and the type of research needed to collect it, isn’t necessarily of interest to and/or falls within the expertise of the researchers carrying out the biomarker discovery. This is not just about changing how research is done, but also supporting scientists to form collaborations that would support demonstrations of clinical utility (for example, those with expertise in health systems, implementation research or test development).
Who leads the prevention agenda? Research projects big and small can suffer from the ‘what’s next’ problem – once project funding has finished, and researchers move on to the next grant, who is responsible for leading the agenda and recommendations? Health is ultimately the responsibility of EU member states, and in the case of personalised prevention, this also requires consideration around how health interventions intersect with interventions in other sectors such as education, housing and transport to promote the personalised prevention agenda. Policy leadership at the EU level could provide national governments with a toolkit for implementation strategies, and also share examples of best practice for nations to follow, rather than starting from scratch.
A need for European resources. It was pointed out by a few meeting participants that there is a need to develop European-led scientific support resources, rather than relying on mostly US-provided resources. Examples given included Amazon cloud services for storing data and genetics resources such as ClinVar, with one participant proposing a European Genome Institute. Progress is being made via the European Health Data Space but there is a need to take a wider view of areas that would benefit most from attention, and funding.
Overall, the PROPHET project has developed many of the policy building blocks to support implementation of personalised prevention, however there is still work to be done to make this a reality for citizens.
If you would like to know more about this project, please contact Laura Blackburn.
UK participant in Horizon Europe Project PROPHET is supported by UKRI grant number 10040946 (Foundation for Genomics & Population Health)
