Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 4, 2024
Date Accepted: Feb 27, 2025
Combined Use of Digital and Analog Physical Therapy in Patients With Musculoskeletal Disorders and Indicators of Chronicity: A German Claims Data Analysis
ABSTRACT
Background:
Musculoskeletal disorders are prevalent worldwide and contribute significantly to the overall burden of disease. In Germany, the introduction of digital health applications (DiGAs) aimed to enhance the accessibility of digital health interventions for all statutory health insurance members. However, DiGAs have yet to be incorporated into medical guidelines, leaving their current utilization to the discretion of individual healthcare professionals.
Objective:
Based on claims data, this study aimed to examine the current usage of DiGAs for musculoskeletal disorders. It focused specifically on comparing digital to in-person physical therapy and the use of other therapeutic measures.
Methods:
This retrospective observational study analyzed claims data from Germany's largest statutory health insurance company. Patients who used DiGA for musculoskeletal disorders at least once were included. The sociodemographic and medical characteristics of patients receiving supplementary physical therapy to DiGA and those not receiving additional physical therapy were compared. Statistics included univariate analyses and binomial logistic regression.
Results:
Of the 6,090 individuals, 58.18% (3,543/6,090) were prescribed physical therapy within six months before or after DiGA (self-)prescription. In the study population, 36.29% (2,210/6,090) experienced an overlap of DiGA and physical therapy. The likelihood of physical therapy increased significantly with higher chronicity risk, female gender, higher age, and the type of DiGA. Patients with indicators of chronicity were nearly three times more likely to use additional physical therapy compared to those without such indicators (OR = 2.76, 95% CI 2.22-3.47, P<.001).
Conclusions:
Chronicity emerged as an important predictor for additional physical therapy. The findings highlight the integral role of DiGAs in the comprehensive care of musculoskeletal disorders, particularly in managing complex cases. Thus, establishing interfaces between analog and digital therapies and fostering interdisciplinary collaboration among healthcare providers are recommended for implementing blended care models. Clinical Trial: N/A
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