Healthcare professionals' attitudes towards digital health interventions and perspectives on digital health inequalities in cardiometabolic care: a qualitative study.

BACKGROUND

The ue of digital health interventions (DHIs) for the management of cardiometabolic diseases has increased but may exacerbate existing health inequalities. Healthcare professionals (HCPs) play a vital role in recommending and supporting healthcare users to use these tools. There is a need to understand the role of HCPs in managing the implementation of digital health in communities at risk of health inequalities.

OBJECTIVE

To explore the views of HCPs regarding digital health and its impact on health inequalities, focusing on cardiometabolic diseases and the South Asian population in the UK.

DESIGN

We conducted online semi-structured interviews and focus groups with HCPs. These explored HCPs' experiences and attitudes towards digital health, their perceptions of healthcare users' barriers and facilitators to use such tools, as well as digital inequalities among specific healthcare user groups, and the impact of the COVID-19 pandemic on their practice in relation to digital health. After informed consent, transcription and coding, a reflexive thematic approach was taken for analysis.

SETTING

Primary, community and secondary care provided for cardiometabolic disease in the UK.

PARTICIPANTS

HCPs in general practice (n=3), cardiometabolic specialities (n=3), pharmacy (n=4) and other practices (n=8).

RESULTS

HCPs recognised the potential benefits of DHIs to improve access and delivery of care and healthcare user outcomes but described several barriers to successful implementation. HCPs demonstrated a good understanding of the challenges their healthcare users face in relation to wider inequalities, barriers to health behaviours and healthcare access, and digital health. Of particular concern was the impact of increasing reliance on digital interventions in healthcare on the exclusion of some population groups. Participants recommended improvement of the design and implementation of DHIs offered to healthcare users through working with at-risk populations throughout the process. Finally, participants emphasised the importance of ensuring non-digital services remained available to ensure equitable access to health and social care.

CONCLUSIONS

HCPs described the complexities of delivering care to underserved communities. DHIs were identified as a potential way to improve health outcomes for some, while over-reliance risked exacerbating inequalities. HCPs made recommendations related to design, implementation and engaging target populations and provided practical examples to address digital health inequalities, such as working with other sectors to take a community approach.