Results from patent reports (PRO) are playing an increasing role in the evaluation of therapies and other health services to quantify their impact on the health of the population. Although PROs are well accepted today as a primary evaluation outcome (e.g. new drugs), little attention has been paid to them when they were established as a standard for the evaluation of digital public health interventions (DPHI). Another aspect in supporting the impact of DPHI on the health of the population is its successful implementation in current health care structures. However, DPHI often do not have an adequate implementation strategy. Once DPHI are available, they are considered self-sufficient systems that provide the same services as under controlled conditions. Therefore, the research goal is to investigate the potential role of PRO for DPHI and to provide strategies for the implementation of DPHI in health care systems. For this purpose, different methods are used, ranging from scoping reviews to mixed approaches, which include qualitative and quantitative research methods. The research aims to highlight the importance of PRO in the context of DPHI and public health and to provide implementation strategies for DPHI. The application of different research methods by different research projects dealing with DPHI in the coming years may contribute to this goal.

Research Draft

PRO is a collective term for measures based on patient evaluations. These include psychosocial constructs such as health-related quality of life, patient preferences, patient satisfaction or perceived disease symptoms. PRO data can be collected by means of self-completed questionnaires or surveys. As a result, PRO are often used as a means of capturing patient rather than clinical or other outcomes perspectives and as such can play an increasing role in the evaluation of therapies and other health services to quantify their impact on the health of the population. Although PROs are widely accepted today as the primary outcome of evaluation, little attention has been paid to their establishment as a standard for the evaluation of digital public health interventions (DPHI). With the current developments in the German health care system for the evaluation of DPHI, such as apps as medical devices by the Federal Institute for Drugs and Medical Devices (BfArM), the importance of PROs is likely to increase to a level comparable to that of drug approval.

Another aspect of supporting the impact of DPHI on the health of the population is their successful implementation in current health care structures. There are many examples of problematic implementation of health interventions in health care facilities. It is increasingly recognized that the way interventions are implemented is equally important for realizing the full potential of the interventions. Implementation strategies have been described as the "how" of implementation science, which includes the specific means or methods used to adopt and maintain interventions. However, DPHI often do not have an adequate implementation strategy. Once DPHI are available, they are considered to be self-sufficient systems that perform as well as under controlled conditions. DIPHs can be seen as an example of complex interventions that are difficult to implement because of factors such as interoperability, adaptation to existing systems, disruption of interactions between health professionals and patients, or low technology adoption. Given the increasing use of DIPHs and their enhanced role in healthcare, it is crucial to understand how they can best be implemented.

Therefore, the research goal for the coming years is to explore the potential role of PRO for DPHI in capturing the patient perspective and to provide strategies for the implementation of DPHI in health care systems to enable them to reach their full potential. This will be done using a variety of methods, ranging from scoping reviews to mixed methodological approaches that include qualitative and quantitative research methods, drawing on experience from previous on- and offline intervention studies that mainly consisted of multimodal, complex interventions. Health psychological interventions to change health behavior can serve as case studies for DPHI, since the field provides extensive evidence from online and mobile interventions and effective intervention components in taxonomic systems are well described and structured. Despite their often proven effectiveness under controlled conditions, such evidence-based interventions to change health behavior slowly make it into the primary health care market, and when they do establish themselves, little or nothing is known about their effectiveness, i.e., how they work in the health care system under uncontrolled, real-world conditions.

Contact
Dr. Julian Wienert
Leibniz Institute for Prevention Research and Epidemiology – BIPS
Department for Prevention and Evaluation
Achterstraße 30
28359 Bremen, Gemany
Phone: +49 (0)421 218-56920
Mail: wienert@leibniz-bips.de
Websites: BIPS | ResearchGate