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关于移动健康应用程序如何引入德国标准高血压护理的见解:对德国心脏病专家和全科医生的定性研究

Insights Into How mHealth Applications Could Be Introduced Into Standard Hypertension Care in Germany: Qualitative Study With German Cardiologists and General Practitioners.

作者信息

May Susann, Seifert Frances, Bruch Dunja, Heinze Martin, Spethmann Sebastian, Muehlensiepen Felix

机构信息

Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany.

Department of Cardiovascular Surgery, Heart Center Brandenburg, Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Germany.

出版信息

JMIR Mhealth Uhealth. 2025 Mar 28;13:e56666. doi: 10.2196/56666.

DOI:10.2196/56666
PMID:40153776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11992499/
Abstract

BACKGROUND

Mobile health (mHealth) apps provide innovative solutions for improving treatment adherence, facilitating lifestyle modifications, and optimizing blood pressure control in patients with hypertension. Despite their potential benefits, the adoption and recommendation of mHealth apps by physicians in Germany remain limited. This reluctance may be due to a lack of understanding of the factors influencing physicians' willingness to incorporate these digital tools into routine clinical practice. Understanding these factors is crucial for fostering greater integration of mHealth apps in hypertension care.

OBJECTIVE

The aim of this study was to explore the relationship between physicians' information needs and acceptance factors, and how these elements can support the effective integration of mHealth apps into daily medical routines.

METHODS

We conducted a qualitative study involving 24 semistructured telephone interviews with physicians, including 14 cardiologists and 10 general practitioners, who are involved in the treatment of hypertensive patients. Participants were selected through purposive sampling to ensure a diverse range of perspectives. Thematic analysis was conducted using MAXQDA software (Verbi GmbH) to identify key themes and subthemes related to the acceptance and use of mHealth apps.

RESULTS

The analysis revealed significant variability in physicians' information needs regarding mHealth apps, particularly concerning their functionalities, clinical benefits, and potential impact on patient outcomes. These informational gaps play a critical role in determining whether physicians are willing to recommend mHealth apps to their patients. Key determinants influencing acceptance were identified, including the availability of robust knowledge about the apps, high-quality and reliable data, generational shifts within the medical profession, solid evidence supporting the effectiveness of the mHealth apps, and clearly defined areas of application and responsibilities within the physician-patient relationship. The study found that acceptance of mHealth apps could be significantly increased through targeted educational initiatives, enhanced data quality, and better integration of these tools into existing clinical workflows. Furthermore, younger physicians, more familiar with digital technologies, demonstrated greater openness to using mHealth apps, suggesting that generational changes may drive future increases in adoption.

CONCLUSIONS

The successful integration of mHealth apps into hypertension management requires a multifaceted approach that addresses both the informational and practical concerns of physicians. By disseminating comprehensive knowledge about the variety, functionality, and proven efficacy of hypertension-related mHealth apps, health care providers can be better equipped to use these tools effectively. This approach necessitates the implementation of various knowledge transfer strategies, such as targeted training programs, peer learning opportunities, and active engagement with digital health technologies. As physicians become more informed and confident in the use of mHealth apps, their acceptance and recommendation of these tools are likely to increase, leading to more widespread adoption. Overcoming current barriers related to information deficits and data quality is essential for ensuring that mHealth apps are optimally used in routine hypertension care, ultimately improving patient outcomes and enhancing the overall quality of care.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00029761; https://drks.de/search/de/trial/DRKS00029761.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3389/fcvm.2022.1089968.

摘要

背景

移动健康(mHealth)应用程序为改善治疗依从性、促进生活方式改变以及优化高血压患者的血压控制提供了创新解决方案。尽管它们具有潜在益处,但德国医生对mHealth应用程序的采用和推荐仍然有限。这种不情愿可能是由于对影响医生将这些数字工具纳入常规临床实践意愿的因素缺乏了解。了解这些因素对于促进mHealth应用程序在高血压护理中的更大整合至关重要。

目的

本研究的目的是探讨医生的信息需求与接受因素之间的关系,以及这些因素如何支持mHealth应用程序有效融入日常医疗流程。

方法

我们进行了一项定性研究,对24名参与高血压患者治疗的医生进行了半结构化电话访谈,其中包括14名心脏病专家和10名全科医生。通过目的抽样选择参与者,以确保观点的多样性。使用MAXQDA软件(Verbi GmbH)进行主题分析,以确定与mHealth应用程序的接受和使用相关的关键主题和子主题。

结果

分析显示,医生对mHealth应用程序的信息需求存在显著差异,特别是在其功能、临床益处以及对患者结局的潜在影响方面。这些信息差距在决定医生是否愿意向患者推荐mHealth应用程序方面起着关键作用。确定了影响接受度的关键决定因素,包括有关应用程序的丰富知识的可用性、高质量和可靠的数据、医学专业内部的代际转变、支持mHealth应用程序有效性的确凿证据,以及医患关系中明确界定的应用领域和责任。研究发现,通过有针对性的教育举措、提高数据质量以及将这些工具更好地整合到现有临床工作流程中,可以显著提高对mHealth应用程序的接受度。此外,更熟悉数字技术的年轻医生对使用mHealth应用程序表现出更大的开放性,这表明代际变化可能推动未来采用率的提高。

结论

将mHealth应用程序成功整合到高血压管理中需要采取多方面的方法,解决医生的信息和实际问题。通过传播有关高血压相关mHealth应用程序的种类、功能和已证实疗效的全面知识,医疗保健提供者可以更好地有效地使用这些工具。这种方法需要实施各种知识转移策略,如针对性的培训计划、同行学习机会以及积极参与数字健康技术。随着医生对mHealth应用程序的使用更加了解和自信,他们对这些工具的接受和推荐可能会增加,从而导致更广泛的采用。克服当前与信息不足和数据质量相关的障碍对于确保mHealth应用程序在常规高血压护理中得到最佳使用至关重要,最终改善患者结局并提高整体护理质量。

试验注册

德国临床试验注册中心DRKS00029761;https://drks.de/search/de/trial/DRKS00029761。

国际注册报告识别号(IRRID):RR2-10.3389/fcvm.2022.1089968。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1292/11992499/362ff834dfbf/mhealth_v13i1e56666_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1292/11992499/62730dfbf6de/mhealth_v13i1e56666_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1292/11992499/362ff834dfbf/mhealth_v13i1e56666_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1292/11992499/62730dfbf6de/mhealth_v13i1e56666_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1292/11992499/362ff834dfbf/mhealth_v13i1e56666_fig2.jpg

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JMIR Mhealth Uhealth. 2024 Jan 17;12:e48345. doi: 10.2196/48345.
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Factors Influencing the Acceptance and Adoption of Mobile Health Apps by Physicians During the COVID-19 Pandemic: Systematic Review.在 COVID-19 大流行期间影响医生接受和采用移动医疗应用程序的因素:系统评价。
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