Zusammenfassung
Digitale Gesundheitsanwendungen haben das Potential den Zugang zu relevanten Zielgruppen zu verbessern, Interventionen individuell zuzuschneiden und insgesamt die Qualität/Wirksamkeit der Versorgung zu verbessern. Die Evaluation dieser digitalen Gesundheitsanwendungen ist jedoch mit zahlreichen Herausforderungen verbunden. Die Analysen von Care4Saxony können dazu beitragen diese Herausforderungen besser zu verstehen und damit schrittweise zu bewältigen.
Abstract
Digital health applications have the potential to improve the access to relevant target groups, to individually tailor interventions and to improve overall quality/effectiveness of care. However, the evaluation of digital health applications is coming with a number of challenges. The analyses of Care4Saxony may contribute to an improved understanding of these challenges and thereby may help to handle them step by step.
Telemedizin soll den Zugang zu Zielgruppen sowie Versorgungsqualität und das Selbstmanagement chronisch Kranker verbessern . Eine telemedizinsche Versorgung liegt dann vor, wenn (1) unter Beteiligung eines Leistungserbringers, (2) IuK-Technologie in der Versorgung verwendet wird, um (3) eine Distanz zu überbrücken . Bisher fehlt es jedoch an einem evidenzbasierten „best-practice-Ansatz“ zur Evaluation digitaler Gesundheitsanwendungen.
Zentrale Herausforderungen bei der Evaluation liegen zum einen in den Anwendungen selbst. Telemedizinische Versorgungsformen nutzen eine Vielzahl unterschiedlicher Technologien, wie e-Mail, Nachrichtendienste, Video, Smartphones, Tablets, Systeme der Entscheidungsunterstützung . Diese heterogenen Ausspielwege und ihre individuelle Handhabe erschweren die standardisierte Evaluation.
Entgegen pharmakologischer Interventionen, welche überwiegend einen kausalen (patho-)physiologischen Wirkmechanismus adressieren ist dies bei digitalen Gesundheitsanwendungen oft nicht möglich . Innovative digitale Anwendungen in der Diabetesversorgung verbinden oftmals mehrere Interventionsteile (Funktionen) wie die kontinuierliche Blutzuckermessung, ein Ernährungstagebuch, automatisiertes Feedback oder motivierende Textnachnachrichten. Dies erschwert die Bewertung der kausalen Wirkungsbeziehung der Intervention(sbestandteile) zu einem gemessenen Effekt.
Neben diesen unklaren Wirkmechanismen leiden eine Vielzahl der verfügbaren Studien unter methodischen Schwächen, welche überwiegend ein fehlendes Parallelgruppendesign, fehlende Verblindung, fehlende Randomisierung und geringe Größe der Studienpopulation betreffen . Dies führt dazu, dass die Evidenz für digitale Gesundheitsanwendungen limitiert ist und eine Empfehlung im Rahmen von Leitlinien bisher nur bedingt erfolgt.
Um mehr über zielgruppen- und interventionsspezifische Wirksamkeit zu erfahren, klicken Sie hier.
Literaturverzeichnis
{1908008:I72ZM3DM},{1908008:R25B6382};{1908008:G4ZMD9KW};{1908008:TJVPLL5A};{1908008:J3PID2MS};{1908008:CFPHSLN7};{1908008:S3IQK33X} apa author asc no 3956
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