Prioritized barriers to implementation of personalized immunotherapy for sepsis patients.

BACKGROUND: Sepsis remains a leading cause of mortality despite increased adherence to clinical guidelines. Personalized immunotherapy, tailored to individual immune profiles, holds promise as an adjunctive treatment. Understanding of barriers influencing decision-making is essential for developing appropriate implementation strategies to promote the uptake of personalized immunotherapy into routine practice. Identifying barriers early, before personalized immunotherapy is included in clinical guidelines, can help accelerate its implementation in the future. This study aims to prioritize these barriers.

METHODS: A cross-sectional survey was conducted among healthcare professionals involved in the care of patients with infectious diseases. Using maximum difference scaling, 29 barriers were ranked according to their perceived relevance. The mean relative importance score of each barrier was calculated using hierarchical Bayes estimation for the total sample, as well as separately for groups with low versus high levels of experience with immunotherapy for patients with infectious diseases. These scores were used to rank barriers, with higher scores indicating higher relative importance.

RESULTS: A total of 174 healthcare professionals completed the survey. The most relevant barriers identified were lack of protocols and insufficient scientific evidence. Regarding the remaining barriers, healthcare professionals with less immunotherapy experience prioritized individual-level barriers, such as insufficient domain knowledge, while those with more experience prioritized organizational-level barriers, such as insufficient priority from hospital management. Barriers related to team processes and patient outcome expectations were ranked low by both groups.

CONCLUSIONS: This study highlights the need for a multifaceted implementation strategy to effectively introduce personalized immunotherapy for sepsis patients. Strategies should be tailored to varying levels of immunotherapy experience of healthcare professionals.

© 2026. The Author(s).

PMID: 41764536