Keywords: evidence based medicine, prevention, public health, adherence.

Background:

The web based program called “Check Me” was developed as a personalized health assessment tool that automatically estimates individual disease risk based on patient-specific factors, including age, sex, emotional status, lifestyle habits, and the presence of chronic conditions. Despite its individualized, risk-based approach, a subset of users not always adhere to the recommended screening tests, which may limit the overall effectiveness of the prevention company in primary care.

Research questions:

To identify factors influencing patients’ adherence to personalized diagnostic recommendations generated by the Check Me program.

Method:

A survey was conducted among patients of the “Interfamily” clinic who received a personalized screening plan generated by their physicians using the Check Me program. Follow-up phone interviews were conducted three weeks after the visit. Open-ended questions “Why did you not attend the medical check-up?” were used. Responses were recorded verbatim. Qualitative data were independently analyzed by two experts with subsequent transcription. Non-verbal elements of communication, including pauses, sighs, and exclamations, were also documented.

Results:

Thematic analysis revealed several factors associated with non-adherence, including lack of time, low prioritization of preventive care in the absence of symptoms, and forgetfulness. Some participants expressed skepticism regarding the necessity of recommended tests. Additional barriers included psycho-emotional factors, financial constraints, and technical difficulties related to program use.

Conclusions:

Non-adherence to personalized preventive recommendations generated by the Check Me program is multifactorial and influenced by behavioral, emotional, financial, and technical factors. Addressing these barriers should be considered when optimizing advisory strategies and improving patient engagement in preventive healthcare.

Points for discussion:

How do behavioral, psycho-emotional, organizational, and technical factors interact to influence patients’ engagement with and adherence to recommendations provided by the personalized Check Me advisor?

What modifications to the design and implementation of the Check Me program could reduce identified barriers and strengthen facilitators to improve patient use of preventive examination recommendations?