Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 22, 2023
Date Accepted: Jun 15, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Healthcare professionals’ key considerations when developing and implementing digital technology for early detection of dementia-causing diseases: qualitative approach
ABSTRACT
Background:
The World Health Organisation (WHO) promotes using digital technologies to accelerate global attainment of health and well-being. This has led to a growth in research exploring the use of digital technology to aid early detection and preventative interventions for dementia causing diseases, such as Alzheimer’s. The opinions and perspectives of healthcare professionals must be incorporated into the development and implementation of technology to promote its successful adoption in clinical practice.
Objective:
This study aimed to explore healthcare professionals’ perspectives on the key considerations of developing and implementing digital technologies for the early detection of dementia causing diseases within the National Health Service (NHS).
Methods:
Healthcare professionals with patient-facing roles within primary or secondary care settings in the NHS were recruited through various online NHS clinical networks. Participants were interviewed to explore their experiences of the current dementia pathway, views on early detection and use of digital technology to aid this, and the challenges of implementing such interventions into healthcare. An inductive thematic analysis approach was applied to identify themes within the interviews. A list of main and sub-themes was applied systematically to the whole data set using QSR N-Vivo (Version 1.6.1). Using the ‘constant comparison’ technique, the researchers moved backwards and forwards between these data and evolving explanations until a fit was made.
Results:
Eighteen semi-structured interviews were conducted with 11 primary and seven secondary care healthcare professionals. We identified three main categories of consideration relevant to healthcare service users, healthcare professionals, and surrounding the digital health technology itself. Healthcare professionals recognised the potential of using digital technology to collect real-time data, and the possible benefits of detecting dementia causing diseases earlier if an effective intervention was available. However, some were concerned about post-detection management, questioning “if you can’t do anything about it then what’s the point” (P1 GP) as it could create a “tidal wave of anxious people that you [healthcare services] can’t manage” (P3 GP). Healthcare professionals also expressed mixed opinions on who should be screened for early detection. Some suggested it should be made “widely available” (P3 GP) to ensure we are “not excluding people who already are in digital poverty” (P5 GP), whilst others were concerned about “the amount of resource to go into screening people under the age of 65 [and are asymptomatic] [...] would seem disproportionate to the number of cases picked up” (P2 GP).
Conclusions:
This study highlights the need to design digital health technology in a way that is accessible to all and does not add burden to healthcare professionals. Further work is needed to ensure inclusive strategies are used in digital research to promote health equity.
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