How General Practitioners Feel About Prescription mHealth Apps

It is necessary to understand the expectations and fears of general practitioners in order to motivate them to recommend mobile health (mHealth) apps to their patients.

The results of the study demonstrated the need to provide appropriate education and training to enhance general practitioners’ digital skills. Further, the findings highlighted the need to overcome technical issues like interoperability between data collection and medical records to limit the disruption of medical work because of data flow.

Aline Sarradon-Eck, M.D., Ph.D., and colleagues investigated French general practitioners’ attitudes toward the prescription of mHealth apps or devices aimed toward patients. They analyzed practitioners’ perceptions and expectations of mHealth technologies.

The team interviewed 20 general practitioners who were in private practice. They interviewed practitioners who were at different stages in their career trajectory, worked in areas with different population densities, and worked in solo or group practice.

A medical sociologist conducted individual interviews. Participants were contacted by email and interviews were conducted face-to-face at the physician’s office for a duration of 28 to 87 minutes. Focus groups were conducted by an experienced moderator. The moderators and interviewers used a guide to conduct discussions. The guide covered knowledge and interest in digital technologies, possible use of mHealth apps, experience recommending mHealth apps or devices, effects on doctor-patient relationship, risks and benefits for the patient, doubts and fears, and effects on patient responsibility and autonomy.

Transcripts of the interviews were coded using an iterative inductive process. First, they used initial coding and segments of transcripts were coded into categories until they accounted for all the variations in the data. Then selective coding and relationships between the categories were refined and core categories were identified and arranged into broad thematic categories. The third step was aimed at identifying the core phenomenon, causal conditions, resultant strategies, context, and consequences.

Data were reassembled into four themes: willingness (apps as additional resources to medical work), skepticism or resistance, high value of the apps for the patient, and less value of the apps and risk for the patient. Three groups of attitudes or positions adopted by the practitioners were identified and defined: digital engagement, patient protection, and doctor protection.

Digital Engagement

There were some general practitioners who adopted a fairly favorable position for mHealth and perceived apps as additional resources. These practitioners were familiar with the tools, had used professional apps, and had even tested some mHealth apps. Among the 20 practitioners interviewed, 10 used professional apps, 11 knew of one or more mHealth apps aimed toward patients, and six had previously advised an mHealth app to their patients. Still, most of them reported a lack of knowledge or familiarity with the tools and even lacked interest. But they expressed a desire to gain more digital skills.

The main benefit was the facilitation of medical work and follow-up care. Practitioners emphasized the importance of reliability and objectivity of measurements allowed by the app, the traceability, and the possibility of a history of measurements that facilitate medical work in terms of diagnosis and patient care plans.

Patient Protection

Practitioners were worried about their patients and the possible risks mHealth apps could bring them. Some risks were related to smartphone use such as addition to smartphones, dangers of cell phone radiation, and distortion of ongoing relationships and cognitive changes. There was also worry about the security of the apps and concerns over patient data privacy.

Doctor Protection

Some practitioners had an attitude that aimed to protect their work and professional position and viewed the prescription of apps as an additional task. Other practitioners felt apps would offer scattered information that might generate a lot of questions from patients.

Further, they believed the management of patient-gathered health data would create extra work and increase their workload, especially because of the lack of interoperability between the apps and the electronic health record.

The study, “Attitudes of General Practitioners Toward Prescription of Mobile Health Apps: Qualitative Study,” was published online in the Journal of Medical Internet Research mHealth and uHealth.