Background/Purpose: Rheumatic and musculoskeletal diseases (RMDs) are chronic conditions that require complex, multidisciplinary care. Since 2020, digital health applications (DiGAs) have been available for prescription and reimbursement in Germany, offering potential support for patient self-management. However, data on patient awareness, willingness to use, suitability, and actual adoption of DiGAs among individuals with RMDs remain limited. This study aimed to evaluate both the potential and actual adoption of DiGAs by patients with RMDs.

Methods: A national cross-sectional survey was conducted between February 17 and April 8, 2025, across multiple German rheumatology outpatient clinics. Adult patients presenting to the clinics were invited to complete an anonymous electronic REDCap questionnaire.

Results: A total of 246 patients completed the survey (mean age 50.4 years; 71.1% female). Most participants were treated at a university hospital (59.8%), primarily for rheumatoid arthritis (41.1%), psoriatic arthritis (18.3%), or axial spondyloarthritis (10.2%) (Table 1). Regarding digital health usage (Figure 1), 9.5% of patients reported prior medical app usage, 39.8% were aware of DiGAs, and 12.6% had previously used a DiGA. Additionally, 84.6% of patients reported at least one comorbidity corresponding to an approved DiGA indication; the most frequently reported indications were back pain (54.8%), chronic pain (52.0%), and sleep disorders (35.8%), see Figure 2. Importantly, 72.4% of patients expressed willingness to regularly use a DiGA, and 72.8% would welcome active DiGA recommendations from their rheumatologists or insurance providers. Finally, 76.0% expressed interest in a rheumatology-specific DiGA.

Conclusion: The majority of patients reported comorbidities potentially addressable with DiGAs and expressed interest in regular use. However, only a minority had previously used a DiGA. These findings highlight the need for enhanced implementation strategies to fully leverage the potential of digital health applications.

Table 1: Patient demographics.

Figure 1: Sankey diagram illustrating patients’ medical app usage, DiGA awareness, DiGA usage, DiGA indications, willingness to use DiGAs, interest in receiving DiGA recommendations, and interest in a rheumatology-specific DiGA.

Figure 2: Patient-reported comorbidities that represent indications for approved prescribable digital health applications (DiGAs). Participants were allowed to select multiple comorbidities. Light blue depicts the proportion of patients with the reported respective indication. Green depicts the proportion of patients with the reported respective indication and reported willigness to regularly use a DiGA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/digital-empowerment-on-hold-adoption-gaps-in-prescribable-digital-health-applications-a-national-cross-sectional-study-from-germany/