JMIR Publications

ABSTRACT

Background:

A gap exists between the development of digital health technologies (DHTs) and the needs and capabilities of patients with stroke. Understanding the perspectives of patients, caregivers, healthcare professionals, and other stakeholders is essential for integrating DHTs into post-stroke care.

Objective:

To synthesize stakeholder perspectives relevant to the implementation of DHTs in post-stroke self-management and rehabilitation, and to organize these perspectives within the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework.

Methods:

Six databases (PubMed, MEDLINE, Embase, Scopus, CINAHL, and Web of Science) were searched from inception through October 2025. Two reviewers independently screened the records. Eligible studies were English-language, peer-reviewed, primary research using qualitative, quantitative or mixed methods designs, which reported on the stakeholder perspectives of DHTs in post-stroke care. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Findings were first synthesized inductively through qualitative content analysis and then mapped deductively to the NASSS framework.

Results:

Of 15,262 records identified, 42 studies (24 qualitative, 8 quantitative, and 10 mixed-methods), published between 2019 and 2025, met the inclusion criteria. Patients, caregivers, healthcare professionals, and members of the public generally viewed DHTs positively, but implementation was constrained by stroke-related motor, cognitive, communication, and sensory limitations; unequal digital access and literacy; dependence on caregiver or professional support; and poor integration with routine care. Personalization, simple interfaces, timely feedback, and human support were consistent facilitators. Evidence on organizational readiness, regulation, reimbursement, and longitudinal adaptation was limited.

Conclusions:

Implementing DHTs in post-stroke care requires accessible, person-centred design; support for patients, caregivers, and healthcare professionals; and alignment with clinical workflows, governance, and financing. The NASSS framework can guide prospective implementation evaluation, but longitudinal studies are needed before claims about scale-up and sustainability can be made.