Schultz Adrian, Luppa Melanie, Bleckwenn Markus, Riedel-Heller Steffi G, Zuelke Andrea
Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany.
Institute of General Practice, Leipzig University, Leipzig, Germany.
JMIR Form Res. 2025 Jan 22;9:e56310. doi: 10.2196/56310.
eHealth interventions constitute a promising approach to disease prevention, particularly because of their ability to facilitate lifestyle changes. Although a rather recent development, eHealth interventions might be able to promote brain health and reduce dementia risk in older adults.
This study aimed to explore the perspective of general practitioners (GPs) on the potentials and barriers of eHealth interventions for brain health. Understanding the perspective of GPs allows us to identify chances and challenges for implementing eHealth apps for dementia risk reduction.
We conducted semistructured expert interviews with 9 GPs working in an outpatient setting in and near Leipzig, Germany. Data were fully transcribed and analyzed using a process model of qualitative content analysis with codes and categories being constructed inductively and deductively.
We found generally favorable but balanced views of eHealth apps for brain health. Eight themes were identified and elaborated on in the data as follows: "addressing dementia," "knowledge about dementia," "need for information," "potential for prevention," "chances for apps for prevention," "development of apps for prevention," and "barriers of apps for prevention." GPs talked mostly about how and when to address dementia and the requirements for their use of eHealth apps for dementia prevention. GPs stated that they only addressed dementia once abnormalities were already present or less frequently when a patient or relative expressed a direct wish, while individual dementia risk or standardized diagnostic during routine check-ups were mentioned much less frequently. According to GPs, knowledge about dementia in patients was low; therefore, patients expressed little need for information on dementia risk factors and prevention in GP practices. Most patients wished for quick information regarding diagnostics, treatment options, and progression of the disease. GPs mentioned a lack of overview of the available eHealth apps and their content. They also expressed a fear of inducing health anxiety when talking to patients about risk factors and prevention.
GPs want patients to receive relevant and individualized information. Prerequisites for the use of eHealth apps for dementia prevention were app characteristics related to design and content. GPs need to address dementia more routinely, assess relevant risk factors, and aid patients in a preventive role. Concerns were expressed over limited effectiveness, overwhelming patients, limited use in clinical practice, and only targeting patients with an already low risk of dementia.
电子健康干预是疾病预防的一种很有前景的方法,特别是因为其有助于改变生活方式。尽管是最近才发展起来的,但电子健康干预或许能够促进老年人的大脑健康并降低痴呆风险。
本研究旨在探讨全科医生(GP)对电子健康干预促进大脑健康的潜力和障碍的看法。了解全科医生的看法能让我们识别出为降低痴呆风险而实施电子健康应用程序的机会和挑战。
我们对德国莱比锡市内及周边门诊环境中工作的9名全科医生进行了半结构化专家访谈。数据被全部转录,并使用定性内容分析的过程模型进行分析,代码和类别通过归纳和演绎构建。
我们发现全科医生对促进大脑健康的电子健康应用程序总体持认可但态度较为平衡的看法。数据中识别并详细阐述了八个主题,如下:“应对痴呆”“痴呆知识”“信息需求”“预防潜力”“预防应用程序的机会”“预防应用程序的开发”以及“预防应用程序的障碍”。全科医生主要谈论了如何以及何时应对痴呆,以及他们使用电子健康应用程序预防痴呆的要求。全科医生表示,他们仅在已经出现异常情况时才应对痴呆,或者当患者或亲属直接表达愿望时应对频率较低,而在常规检查中提及个体痴呆风险或标准化诊断的频率要低得多。据全科医生称,患者对痴呆的了解程度较低;因此,患者在全科医生诊所中对痴呆风险因素和预防信息的需求不大。大多数患者希望快速获得有关诊断、治疗选择和疾病进展的信息。全科医生提到缺乏对可用电子健康应用程序及其内容的概述。他们还表示担心在与患者谈论风险因素和预防时会引发健康焦虑。
全科医生希望患者获得相关的个性化信息。使用电子健康应用程序预防痴呆的前提条件是与设计和内容相关的应用程序特征。全科医生需要更常规地应对痴呆,评估相关风险因素,并在预防方面帮助患者。有人对其有效性有限、使患者不堪重负、在临床实践中使用受限以及仅针对痴呆风险已经较低的患者表示担忧。