PMID- 37171838
OWN - NLM
STAT- MEDLINE
DCOM- 20230516
LR  - 20230630
IS  - 1438-8871 (Electronic)
IS  - 1439-4456 (Print)
IS  - 1438-8871 (Linking)
VI  - 25
DP  - 2023 May 12
TI  - Problems and Barriers Related to the Use of Digital Health Applications: Scoping 
      Review.
PG  - e43808
LID - 10.2196/43808 [doi]
LID - e43808
AB  - BACKGROUND: The digitization of health care led to a steady increase in the 
      adoption and use of mobile health (mHealth) apps. Germany is the first country in 
      the world to cover the costs of mHealth apps through statutory health insurance. 
      Although the benefits of mHealth apps are discussed in detail, aspects of 
      problems and barriers are rarely studied. OBJECTIVE: This scoping review aimed to 
      map and categorize the evidence on problems and barriers related to the use of 
      mHealth apps. METHODS: Systematic searches were conducted in the MEDLINE, Embase, 
      and PsycINFO databases. Additional searches were conducted on JMIR Publications 
      and on websites of relevant international organizations. The inclusion criteria 
      were publications dealing with apps similar to those approved in the German 
      health care system, publications addressing problems and barriers related to the 
      use of mHealth apps, and articles published between January 1, 2015, and June 8, 
      2021. Study selection was performed by 2 reviewers. The manuscript was drafted 
      according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and 
      Meta-Analyses extension for Scoping Reviews) checklist. The analysis of the 
      included publications and categorization of problems and hurdles were performed 
      using MAXQDA (VERBI Software GmbH). RESULTS: The database search identified 1479 
      publications. Of the 1479 publications, 21 (1.42%) met the inclusion criteria. A 
      further 8 publications were included from citation searching and searching in 
      JMIR Publications. The identified publications were analyzed for problems and 
      barriers. Problems and barriers were classified into 10 categories ("validity," 
      "usability," "technology," "use and adherence," "data privacy and security," 
      "patient-physician relationship," "knowledge and skills," "individuality," 
      "implementation," and "costs"). The most frequently mentioned categories were use 
      and adherence (eg, incorporating the app into daily life or dropouts from use; 
      n=22) and usability (eg, ease of use and design; n=19). CONCLUSIONS: The search 
      identified various problems and barriers in the context of mHealth apps. Although 
      problems at the app level (such as usability) are studied frequently, problems at 
      the system level are addressed rather vaguely. To ensure optimal use of and care 
      with mHealth apps, it is essential to consider all types of problems and 
      barriers. Therefore, researchers and policy makers should have a special focus on 
      this issue to identify the needs for quality assurance. INTERNATIONAL REGISTERED 
      REPORT IDENTIFIER (IRRID): RR2-10.2196/32702.
CI  - (c)Godwin Denk Giebel, Christian Speckemeier, Carina Abels, Felix Plescher, Kirstin 
      Borchers, Jurgen Wasem, Nikola Blase, Silke Neusser. Originally published in the 
      Journal of Medical Internet Research (https://www.jmir.org), 12.05.2023.
FAU - Giebel, Godwin Denk
AU  - Giebel GD
AUID- ORCID: 0000-0002-4182-1927
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Speckemeier, Christian
AU  - Speckemeier C
AUID- ORCID: 0000-0001-7507-4432
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Abels, Carina
AU  - Abels C
AUID- ORCID: 0000-0003-2138-2944
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Plescher, Felix
AU  - Plescher F
AUID- ORCID: 0009-0008-1739-9931
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Borchers, Kirstin
AU  - Borchers K
AUID- ORCID: 0000-0002-7944-8531
AD  - QM BORCHERS CONSULTING+, Herne, Germany.
FAU - Wasem, Jurgen
AU  - Wasem J
AUID- ORCID: 0000-0001-9653-168X
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Blase, Nikola
AU  - Blase N
AUID- ORCID: 0000-0003-3774-5009
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
FAU - Neusser, Silke
AU  - Neusser S
AUID- ORCID: 0000-0001-9077-7005
AD  - Institute for Healthcare Management and Research, University of Duisburg-Essen, 
      Essen, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20230512
PL  - Canada
TA  - J Med Internet Res
JT  - Journal of medical Internet research
JID - 100959882
SB  - IM
MH  - Humans
MH  - Administrative Personnel
MH  - Germany
MH  - *Mobile Applications
MH  - Technology
MH  - *Telemedicine
PMC - PMC10221513
OTO - NOTNLM
OT  - DHA
OT  - DiGA
OT  - Digital Health Application
OT  - Digitale Gesundheitsanwendungen
OT  - app
OT  - barrier
OT  - mHealth
OT  - mobile health
OT  - mobile phone
OT  - problem
COIS- Conflicts of Interest: None declared.
EDAT- 2023/05/12 13:08
MHDA- 2023/05/15 06:42
PMCR- 2023/05/12
CRDT- 2023/05/12 11:52
PHST- 2022/10/25 00:00 [received]
PHST- 2023/02/27 00:00 [accepted]
PHST- 2023/01/26 00:00 [revised]
PHST- 2023/05/15 06:42 [medline]
PHST- 2023/05/12 13:08 [pubmed]
PHST- 2023/05/12 11:52 [entrez]
PHST- 2023/05/12 00:00 [pmc-release]
AID - v25i1e43808 [pii]
AID - 10.2196/43808 [doi]
PST - epublish
SO  - J Med Internet Res. 2023 May 12;25:e43808. doi: 10.2196/43808.