Attitudes of German General Practitioners Toward eHealth Apps for Dementia Risk Reduction: Qualitative Interview Study

Abstract

Background: eHealth interventions constitute a promising approach to disease prevention, particularly because of their ability to facilitate lifestyle changes. Although a rather recent development, eHealth interventions might be able to promote brain health and reduce dementia risk in older adults.

Objective: This study aimed to explore the perspective of general practitioners (GPs) on the potentials and barriers of eHealth interventions for brain health. Understanding the perspective of GPs allows us to identify chances and challenges for implementing eHealth apps for dementia risk reduction.

Methods: We conducted semistructured expert interviews with 9 GPs working in an outpatient setting in and near Leipzig, Germany. Data were fully transcribed and analyzed using a process model of qualitative content analysis with codes and categories being constructed inductively and deductively.

Results: We found generally favorable but balanced views of eHealth apps for brain health. Eight themes were identified and elaborated on in the data as follows: "addressing dementia," "knowledge about dementia," "need for information," "potential for prevention," "chances for apps for prevention," "development of apps for prevention," and "barriers of apps for prevention." GPs talked mostly about how and when to address dementia and the requirements for their use of eHealth apps for dementia prevention. GPs stated that they only addressed dementia once abnormalities were already present or less frequently when a patient or relative expressed a direct wish, while individual dementia risk or standardized diagnostic during routine check-ups were mentioned much less frequently. According to GPs, knowledge about dementia in patients was low; therefore, patients expressed little need for information on dementia risk factors and prevention in GP practices. Most patients wished for quick information regarding diagnostics, treatment options, and progression of the disease. GPs mentioned a lack of overview of the available eHealth apps and their content. They also expressed a fear of inducing health anxiety when talking to patients about risk factors and prevention.

Conclusions: GPs want patients to receive relevant and individualized information. Prerequisites for the use of eHealth apps for dementia prevention were app characteristics related to design and content. GPs need to address dementia more routinely, assess relevant risk factors, and aid patients in a preventive role. Concerns were expressed over limited effectiveness, overwhelming patients, limited use in clinical practice, and only targeting patients with an already low risk of dementia.

Keywords: brain health; dementia; eHealth; lifestyle; older adults; prevention; primary care; risk factor.