Genie in the bottle? a qualitative study of general practitioners’ perspectives and information needs concerning digital mental health applications in Germany
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Background
The concerning prevalence of mental disorders underscores the need for innovative solutions in outpatient care, including prescription digital therapeutics (DTx) designed as regulated software-based medical products for treatment and disease management. In Germany, approved DTx are called DiGAs (referring to “Digitale Gesundheitsanwendungen”) and can be prescribed since 2020 at the expense of statutory health insurance. However, DiGAs remain underutilized by general practitioners (GPs) in primary care. Although prior research indicated individual barriers to prescription among healthcare professionals, little is known on how acceptance-facilitating strategies could be tailored to GPs’ needs. This study therefore explores GPs’ perspectives on DiGAs in general and for mental health, focusing on their needs and wishes regarding information strategies.
Methods
A qualitative descriptive exploratory study using semi-structured interviews with GPs was conducted within a mixed-methods study in fall 2024. Participants were recruited via GP networks, social media, and fax using a purposive sampling approach. Data was analyzed using qualitative content analysis with deductive-inductive category development.
Results
Thirteen GPs between 27 and 66 years (median: 54 years, female: n = 3; 23%) were interviewed. Twelve participants (92%) had prescribed DiGAs at least once, mostly based on patients’ requests for dealing with depression, insomnia or obesity. Analysis revealed varying levels of perceived knowledge and differing attitudes toward digitalization. Independent information sources, particularly from governmental and regulatory institutions, medical associations, and colleagues were mentioned, while ambivalent views on health insurances were reported. GPs favored information content on the evidence base, indications, usability, and cost effectiveness of DiGAs. In terms of delivery modes, online formats, in-person events, and traditional print media were named.
Conclusions
GPs showed high engagement with DiGA prescriptions despite persistent knowledge gaps and ambivalent attitudes. They expressed expectations regarding information provision, emphasizing concise content from trusted, neutral sources, about central structural aspects (e.g., budgetary impact), delivered through familiar formats such as journals, lectures, and digital platforms. Information strategies should account for limited time resources in primary care and align with established routines. Strengthening institutional support and integrating digital health into medical training may further facilitate the adoption of DiGAs in primary care.
