JMIR Publications

ABSTRACT

Background:

The field of mHealth is in constant expansion. Integrating connected objects and applications for patient healthcare (COA) in clinical practice is a major and complex challenge. General practitioners (GP) are the essential link in a patient’s care pathway. As they are patients’ preferred healthcare intermediaries, GP have an important support role to play in patients’ transition to mHealth since they must be able to both guide and advise them.

Objective:

To identify the factors associated with the willingness of French GP to prescribe COA to their patients.

Methods:

The present study was part of the ApiApps project whose overall objective is to help remove barriers GP face when prescribing COA by developing a custom-built platform to aid them. It is funded by the National Research Agency (ANR-17-CE19-0027). The study included GP recruited from several academic department of general practice of several medical faculties in France (Lyon, Nice, Rouen) and also from mailing lists of academic GP, healthcare professional associations, and social and professional networks. Participants were asked to complete an online questionnaire which collected data on various sociodemographic variables, on indicators of their involvement in continued training programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, as well as indicators characterizing their patient population. Data on their representations and beliefs regarding COA were also collected. Finally, the questionnaire included items to measure specific indicators of GP acceptability of prescribing COA for the management of various pathologies.

Results:

Three quarters (74% (129/174)) of GP declared they were ready to prescribe OCA to their patients. In the multivariate analysis of 174 GP, involvement in continued education programs (OR = 6.17 [1.52-28.72]), ease of communication with their patients (OR = 1.45 [1.13-1.88]), GP-perceived benefits of COA for both patients and for their medical practice and GP-perceived drivers for COA implementation in their medical practice (same indicator) (OR = 1.04 [1.01-1.07]), as well as validation of COA through randomized clinical trials (OR = 1.02 [1.00-1.04]) were all associated with GP willingness to prescribe COA. In contrast, older GP (OR = 0.95 [0.91-0.98]), female GP (OR = 0.26 [0.09-0.69]) and those who perceived risks for the patient and/or for their medical practice (OR = 0.96 [0.94-0.99]) were less inclined to prescribe COA.

Conclusions:

COA were generally seen by GP as useful in general medicine to complement other existing tools and respondents were for the most part favorable to prescribing them. However, the full integration of COA in general medicine will be conditioned by the need for conclusive certification, for transparency (reliable and precise data concerning COA methods of construction and clinical validation), for software aids to assist GP prescribe them, and for COA training programs.