The Perspectives of DM Patients About Barriers to Using Digital Health Technology in Qualitative Study: A Systematic Review

Abstract

Digital health technology (DHT) has been shown to increase the glycemic control index in Diabetes Mellitus (DM) patients. The application of DHT is associated with several barriers from the perspectives of patients, which must be addressed in further development. This systematic review aimed to identify barriers to using DHT from the perspectives of DM patients. A comprehensive search was carried out across four journal databases: Sage, PubMed, Cochrane, and ScienceDirect, utilising specific keywords covering the period from 2012 to 2022. Selected studies were screened using the PRISMA flowchart by setting inclusion and exclusion criteria, followed by quality assessment through Critical Appraisal Skills Program (CASP) checklist and thematic synthesis. The results showed that 11 studies met the inclusion criteria and were classified in the medium-quality category according to CASP analysis. Data extraction and theme synthesis produced 13 themes correlated with barriers to using DHT in DM patients. The challenges encompassed incomplete physical examinations, restricted patient-provider relationships, insufficient disease awareness, limited technological literacy, limites digital infrastructure, extra costs for access, concerns regarding the security of healthcare data and the privacy of patients, perceived irrelevance of content for some users, time constraints, vision impairments, language barriers, technical problems due to poor app design and system failures, and logistical difficulties. Barriers from the perspectives of DM patients when using DHT were extrinsic factors from digital health infrastructure and intrinsic factors such as cost constraints, limited digital literacy, and low patients knowledge.