Barriers and Facilitators to the Implementation of Digital Health Services for People With Musculoskeletal Conditions in the Primary Health Care Setting: Systematic Review.

Autor:	van Tilburg ML; Innovation of Movement Care Research Group, Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands., Spin I; Innovation of Movement Care Research Group, Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands., Pisters MF; Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.; Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands.; Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands., Staal JB; Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.; Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands., Ostelo RW; Department of Health Sciences, Faculty of Science, VU University, Amsterdam Movement Sciences Research Institute, Amsterdam, Netherlands.; Department of Epidemiology and Data Science, Amsterdam University Medical Center, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, Amsterdam, Netherlands., van der Velde M; Innovation of Movement Care Research Group, Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands.; Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands., Veenhof C; Innovation of Movement Care Research Group, Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands.; Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.; Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands., Kloek CJ; Innovation of Movement Care Research Group, Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands.; Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of medical Internet research [J Med Internet Res] 2024 Aug 27; Vol. 26, pp. e49868. Date of Electronic Publication: 2024 Aug 27.
DOI:	10.2196/49868
Abstrakt:	Background: In recent years, the effectiveness and cost-effectiveness of digital health services for people with musculoskeletal conditions have increasingly been studied and show potential. Despite the potential of digital health services, their use in primary care is lagging. A thorough implementation is needed, including the development of implementation strategies that potentially improve the use of digital health services in primary care. The first step in designing implementation strategies that fit the local context is to gain insight into determinants that influence implementation for patients and health care professionals. Until now, no systematic overview has existed of barriers and facilitators influencing the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Objective: This systematic literature review aims to identify barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Methods: PubMed, Embase, and CINAHL were searched for eligible qualitative and mixed methods studies up to March 2024. Methodological quality of the qualitative component of the included studies was assessed with the Mixed Methods Appraisal Tool. A framework synthesis of barriers and facilitators to implementation was conducted using the Consolidated Framework for Implementation Research (CFIR). All identified CFIR constructs were given a reliability rating (high, medium, or low) to assess the consistency of reporting across each construct. Results: Overall, 35 studies were included in the qualitative synthesis. Methodological quality was high in 34 studies and medium in 1 study. Barriers (-) of and facilitators (+) to implementation were identified in all 5 CFIR domains: "digital health characteristics" (ie, commercial neutral [+], privacy and safety [-], specificity [+], and good usability [+]), "outer setting" (ie, acceptance by stakeholders [+], lack of health care guidelines [-], and external financial incentives [-]), "inner setting" (ie, change of treatment routines [+ and -], information incongruence (-), and support from colleagues [+]), "characteristics of the healthcare professionals" (ie, health care professionals' acceptance [+ and -] and job satisfaction [+ and -]), and the "implementation process" (involvement [+] and justification and delegation [-]). All identified constructs and subconstructs of the CFIR had a high reliability rating. Some identified determinants that influence implementation may be facilitators in certain cases, whereas in others, they may be barriers. Conclusions: Barriers and facilitators were identified across all 5 CFIR domains, suggesting that the implementation process can be complex and requires implementation strategies across all CFIR domains. Stakeholders, including digital health intervention developers, health care professionals, health care organizations, health policy makers, health care funders, and researchers, can consider the identified barriers and facilitators to design tailored implementation strategies after prioritization has been carried out in their local context. (©Mark Leendert van Tilburg, Ivar Spin, Martijn F Pisters, J Bart Staal, Raymond WJG Ostelo, Miriam van der Velde, Cindy Veenhof, Corelien JJ Kloek. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 27.08.2024.)
Databáze:	MEDLINE
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