Keywords: Digital Health Applications, Mental Health, General Practitioners

Introduction:

Worldwide, the high number of patients with mental disorders poses challenges for primary healthcare systems since general practitioners (GPs) are oftenthe first care providers for this patient group. In 2020, digital health applications (DHA) were introduced in Germany as a novel type of healthcare financed by the statutory health insurance. DHA for mental disorders (DHA-MD) intend to support outpatient care. However, there is limited evidence on GPs perspectives on the use and benefits of DHA-MD in primary care.

Method:

A mixed-methods study (online survey and qualitative interviews with German GPs) was conducted in 2024. The questionnaire and interview guide were developed based on the domains of the Consolidated Framework for Implementation Research. Descriptive analysis regarding treatment contexts for the use of DHA-MD, GPs’ prescribing behavior and perceived need for DHA-MD was performed. The interviews were analyzed using qualitative content analysis.

Results:

149 GPs participated the survey, 12 were interviewed. The median prescription frequency of DHA-MD per quarter was 1, whereas the median estimated need was 3. Working in digitized practices positively predicted the prescribing behavior. The years of professional experiences of GPs negatively predicted the perceived need. In the interviews, GPs reported they valued DHA-MD as a temporary or supplementary option for bridging waiting times for psychotherapy and considered their effectiveness to be highly dependent on indication and patient adherence. Reported barriers of GPs according to DHA-MD included lacking knowledge about DHA-MD, missing effectiveness studies, and difficulties integrating them into existing care processes.

Conclusions:

GPs are reluctant to prescribe DHA-MD, as the need is considered to be low and their use is primarily seen as a temporary or supplementary treatment option rather than a standalone intervention. There are significant reasons for rejection and barriers that hinder prescription in primary care. Currently, DHA-MD do not seem to be an instrument to support GP care.