Embedding Digital Therapeutics into Primary Care: A New Era of Prescribing and Dispensing

Abstract

Background: The current practice and resource constraints in primary care make the management of mental health and sleep disturbances amenable to digital health interventions (DHIs). However, the enablers and barriers for practice translation has not been concurrently explored across key primary care healthcare professionals (HCPs)

Aims: To explore primary care HCPs attitudes towards DHIs and perceived readiness for practice integration.

Methods: Secondary analysis of two qualitative datasets collected from HCPs enrolled in a clinical trial evaluating SleepFix, an app-based intervention for insomnia. Interviews were guided by a schedule of questions focusing on HCPs current use of DHIs, perceived practice barriers/enablers of implementation, user experience of SleepFix and potential models of care for integrating DHIs into practice. Interviews were transcribed verbatim and thematically analysed.

Results: 45 HCP participants (GP=17, nurse =14, pharmacist=14) were interviewed pre-intervention and 15 (GP=6, nurses=2, pharmacist=1) at post-intervention. While participants appeared more receptive towards using DHIs post-pandemic, they did not feel primary care was ready for embedding DHIs, especially sleep-based interventions, into mainstream care. Participants reiterated the need for reliable point-of-care formularies for DHIs to guide practice. Further, in response to the lack of clarity for how DHIs mapped to the respective professions’ scope of practice and reimbursement structures alternative care models were articulated.

Conclusions: While DHIs show promise for improving patient care, establishing a robust evidence-base and revising the respective professions’ scope of practice scope and reimbursement are necessary.