JMIR Publications

ABSTRACT

Background:

In 2020, the global prevalence of overweight and obesity was approximately 42%. One of the most common secondary diseases associated with these conditions is diabetes mellitus type 2 with a global prevalence of around 10.5% in 2021. Digital health applications (DiHA), which can be prescribed as certified medical devices in Germany, have been shown to effectively support disease management in overweight and diabetic patients. However, there is currently no data available on the DiHA-prescribing behavior of healthcare professionals (HCPs) specializing in hormones and metabolism, nor on potential barriers to prescribing these applications.

Objective:

What is the experience and willingness of HCPs to prescribe DiHA in the field of hormones and metabolism? What patient-relevant healthcare effects (1) could potentially be achieved and (2) have already been observed using these DiHA? What barriers do HCPs perceive in prescribing DiHA?

Methods:

An online questionnaire was developed based on preliminary studies and a literature review consisting of 86 items covering six key areas: experience and willingness to prescribe, healthcare effects, barriers, scientific evidence, digital affinity, and sociodemographics. A total of 6,035 HCPs in Germany were invited to participate in the anonymous survey via the German Diabetes Association between August 2, 2024, and October 9, 2024. Descriptive data analyses, as well as correlation and regression analyses, were conducted.

Results:

A total of 350 HCPs participated in the survey (response rate=5.8%). More than half (53.4%) had never prescribed any of the 54 DiHA available at the time of the survey, with 47.6% citing a lack of experience as the primary reason. Among those who had prescribed a DiHA (46.6%), the majority (85.3%) had prescribed one of the eight DiHA available for obesity or diabetes mellitus. Looking ahead, 40.5% of all surveyed HCPs stated that they were either very unlikely (23.%) or rather unlikely (17.5%) to prescribe these DiHA in the next 12 months. The greatest perceived benefits of DiHA were improvements in self-management, health literacy, and adherence. The main barriers to prescribe DiHA in the field of hormones and metabolism included inadequate reimbursement for ancillary medical services, poor compatibility with existing practice software, and a lack of digital affinity or motivation among patients.

Conclusions:

DiHA have not yet been fully integrated into standard healthcare. To improve prescribing, we recommend integrating DiHA into medical guidelines, ensuring proper reimbursement, and involving HCPs in the pricing and health-economic evaluation of DiHA. The recommendations outlined should be considered to maximize DiHA's potential and improve HCPs acceptance, providing valuable insights for health policy to enhance the integration, reimbursement, and utilization of DiHA.