Acceptability of digital health interventions in perioperative care: a systematic review and narrative synthesis of clinician perspectives
File(s)
Published version
Author(s)
Ahmed, Amal
Ho, Chik Wai
Grant, Yasmin
Archer, Stephanie
Carrington, Emma
Type
Journal Article
Abstract
Objectives: To identify themes relating to clinician acceptability of DHIs in the perioperative setting.
Design: Systematic review and narrative synthesis applying an inductive-deductive framework synthesis approach.
Data sources: Medline, Embase and CINAHL for studies published between inception and March 6, 2023.
Eligibility criteria: Studies with qualitative data on clinician perceptions of DHIs in the context of adult perioperative care.
Data extraction and synthesis: Included studies were coded inductively by a single reviewer. Codes were organised into themes based on conceptual similarities. Collaborative discussions with a second and third reviewer enabled higher-order interpretations and the emergence of subthemes. Themes and subthemes were systematically mapped onto the seven constructs of the Theoretical Framework of Acceptability (TFA).
Results: A total of 3234 publications were identified, of which 18 were selected for inclusion. DHIs studied included telemedicine platforms, mobile health applications, website-based programmes, and EHR-integrated software. The most commonly reported TFA construct was perceived effectiveness, followed by affective attitudes, opportunity costs, ethicality, burden, intervention coherence and self-efficacy.
Conclusions: Clinicians’ acceptance of DHIs is primarily driven by perceived effectiveness. Optimism about the potential for DHIs to enhance care is often overshadowed by concerns about patient safety, privacy, and opportunity costs. As clinicians are key gatekeepers in DHI adoption, these perspectives have a significant impact on the long-term integration of these technologies into perioperative care. Co-creation of DHIs with clinicians is required to ensure future interventions are better aligned with clinical workflows and patient needs, enhancing their utilisation and uptake in the long-term.
Design: Systematic review and narrative synthesis applying an inductive-deductive framework synthesis approach.
Data sources: Medline, Embase and CINAHL for studies published between inception and March 6, 2023.
Eligibility criteria: Studies with qualitative data on clinician perceptions of DHIs in the context of adult perioperative care.
Data extraction and synthesis: Included studies were coded inductively by a single reviewer. Codes were organised into themes based on conceptual similarities. Collaborative discussions with a second and third reviewer enabled higher-order interpretations and the emergence of subthemes. Themes and subthemes were systematically mapped onto the seven constructs of the Theoretical Framework of Acceptability (TFA).
Results: A total of 3234 publications were identified, of which 18 were selected for inclusion. DHIs studied included telemedicine platforms, mobile health applications, website-based programmes, and EHR-integrated software. The most commonly reported TFA construct was perceived effectiveness, followed by affective attitudes, opportunity costs, ethicality, burden, intervention coherence and self-efficacy.
Conclusions: Clinicians’ acceptance of DHIs is primarily driven by perceived effectiveness. Optimism about the potential for DHIs to enhance care is often overshadowed by concerns about patient safety, privacy, and opportunity costs. As clinicians are key gatekeepers in DHI adoption, these perspectives have a significant impact on the long-term integration of these technologies into perioperative care. Co-creation of DHIs with clinicians is required to ensure future interventions are better aligned with clinical workflows and patient needs, enhancing their utilisation and uptake in the long-term.
Date Issued
2025-03-15
Date Acceptance
2024-12-19
Citation
BMJ Open, 2025, 15 (3)
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Volume
15
Issue
3
Copyright Statement
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
License URL
Identifier
10.1136/bmjopen-2024-086412
Subjects
Digital Health Interventions
Narrative Synthesis
Perioperative Care
Publication Status
Published
Article Number
ARTN e086412
Date Publish Online
2025-03-15