[How to overcome barriers to care with digital health applications (DiGA)? A review of the patient pathway for unipolar depression].

Abstract

Digital health applications (DiGA) can play an important role in the treatment of unipolar depression. In Germany, the demand is high, but less than 1% of patients use DiGA, indicating existing barriers to their use. This article provides an overview of access and usage barriers along the patient pathway and discusses possible solutions to improve the dissemination and use of digital therapies.Based on the National Care Guideline (NVL) Unipolar Depression (2022), a patient pathway with the phases of "decision," "access," and "usage" was developed. Using this structure, existing care barriers were identified based on current literature, and solutions were derived. The narrative review shows that various factors hinder the effective use of DiGA. In the decision phase, lack of knowledge about DiGA and lack of trust in their effectiveness are central challenges. In the access phase, data protection concerns and bureaucratic hurdles are significant barriers. During the usage phase, difficulties in application and low adherence lead to limited effectiveness.Several solutions are proposed to overcome these barriers. Comprehensive education about the effectiveness of digital therapies could strengthen trust in DiGA. Improvements in user-friendliness and greater involvement of healthcare providers could increase acceptance and adherence. Additionally, targeted training for professionals and patients could promote the use of DiGA. These insights are also relevant for other areas of digital therapies.