{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:48:12Z","timestamp":1791539292382,"version":"4.3.4"},"reference-count":26,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Ment Health"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n While the number of digital therapeutics (DTx) has proliferated, there is little real-world research on the characteristics of providers recommending DTx, their recommendation behaviors, or the characteristics of patients receiving recommendations in the clinical setting.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study was to characterize the clinical and demographic characteristics of patients receiving DTx recommendations and describe provider characteristics and behaviors regarding DTx.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study used electronic health record data from a large, integrated health care delivery system. Demographic and clinical characteristics of adult patients recommended versus not recommended DTx by a mental health provider between May 2020 and December 2021 were examined. A cross-sectional survey of mental health providers providing these recommendations was conducted in December 2022 to assess the characteristics of providers and recommendation behaviors related to DTx. Parametric and nonparametric tests were used to examine statistical significance between groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 335,250 patients with a mental health appointment, 53,546 (16%) received a DTx recommendation. Patients recommended to DTx were younger, were of Asian or Hispanic race or ethnicity, were female, were without medical comorbidities, and had commercial insurance compared to those without a DTx recommendation (\n P<\/jats:italic>\n <.001). More patients receiving a DTx recommendation had anxiety or adjustment disorder diagnoses, but less had depression, bipolar, or psychotic disorder diagnoses (\n P<\/jats:italic>\n <.001) versus matched controls not recommended to DTx. Overall, depression and anxiety symptom scores were lower in patients recommended to DTx compared to matched controls not receiving a recommendation, although female patients had a higher proportion of severe depression and anxiety scores compared to male patients. Provider survey results indicated a higher proportion of nonprescribers recommended DTx to patients compared to prescribers (\n P<\/jats:italic>\n =.008). Of all providers, 29.4% (45\/153) reported using the suggested internal electronic health record\u2013based tools (eg, smart text) to recommend DTx, and of providers recommending DTx resources to patients, 64.1% (98\/153) reported they follow up with patients to inquire on DTx benefits. Only 38.4% (58\/151) of respondents report recommending specific DTx modules, and of those, 58.6% (34\/58) report following up on the impact of these specific modules.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n DTx use in mental health was modest and varied by patient and provider characteristics. Providers do not appear to actively engage with these tools and integrate them into treatment plans. Providers, while expressing interest in potential benefits from DTx, may view DTx as a passive strategy to augment traditional treatment for select patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/56574","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T11:28:02Z","timestamp":1727868482000},"page":"e56574-e56574","source":"Crossref","is-referenced-by-count":11,"title":["Clinical Use of Mental Health Digital Therapeutics in a Large Health Care Delivery System: Retrospective Patient Cohort Study and Provider Survey"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6729-6817","authenticated-orcid":false,"given":"Samuel J","family":"Ridout","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-8165","authenticated-orcid":false,"given":"Kathryn K","family":"Ridout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6861-7359","authenticated-orcid":false,"given":"Teresa Y","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1019-5852","authenticated-orcid":false,"given":"Cynthia I","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"R1","unstructured":"Digital transformation market size, share & trends analysis report by solution (analytics, mobility), by deployment, by service, by enterprise size, by end-use, by region, and segment forecasts, 2023 - 2030. Grand View Research. 2023. URL: https:\/\/www.grandviewresearch.com\/industry-analysis\/digital-transformation-market [Accessed 02-12-2023]"},{"key":"R2","unstructured":"1H and Q2 2021 digital health funding and M&A report. Mercom Capital Group. 2023. URL: https:\/\/mercomcapital.com\/product\/1h-q2-2021-digital-health-healthcare-it-funding-ma-report [Accessed 19-08-2024]"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.2196\/43730","article-title":"The usability, feasibility, acceptability, and efficacy of digital mental health services in the COVID-19 pandemic: scoping review, systematic review, and meta-analysis","volume":"9","author":"Zhong","journal-title":"JMIR Public Health Surveill"},{"issue":"8","key":"R4","doi-asserted-by":"publisher","DOI":"10.3390\/life12081266","article-title":"Did usage of mental health apps change during COVID-19? A comparative study based on an objective recording of usage data and demographics","volume":"12","author":"Aziz","journal-title":"Life (Basel)"},{"issue":"7","key":"R5","doi-asserted-by":"publisher","DOI":"10.2196\/16228","article-title":"The acceptability and usability of digital health interventions for adults with depression, anxiety, and somatoform disorders: qualitative systematic review and meta-synthesis","volume":"22","author":"Patel","journal-title":"J Med Internet Res"},{"issue":"8","key":"R6","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1177\/08901171211055314","article-title":"Opportunities to integrate mobile app-based interventions into mental health and substance use disorder treatment services in the wake of COVID-19","volume":"35","author":"Satre","journal-title":"Am J Health Promot"},{"issue":"3","key":"R7","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1002\/wps.20472","article-title":"The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials","volume":"16","author":"Firth","journal-title":"World Psychiatry"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.04.046","article-title":"Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials","volume":"218","author":"Firth","journal-title":"J Affect Disord"},{"issue":"10","key":"R9","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1007\/s12671-022-01962-z","article-title":"Effectiveness of mobile-based mindfulness interventions in improving mindfulness skills and psychological outcomes for adults: a systematic review and meta-regression","volume":"13","author":"Tan","journal-title":"Mindfulness"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/14273","article-title":"Efficacy of the mindfulness meditation mobile app \u201cCalm\u201d to reduce stress among college students: randomized controlled trial","volume":"7","author":"Huberty","journal-title":"JMIR Mhealth Uhealth"},{"issue":"4","key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/resprot.7203","article-title":"Managing depressive symptoms in the workplace using a web-based self-care tool: a pilot randomized controlled trial","volume":"6","author":"Hirsch","journal-title":"JMIR Res Protoc"},{"issue":"9","key":"R12","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12091376","article-title":"Potential and pitfalls of mobile mental health apps in traditional treatment: an umbrella review","volume":"12","author":"Koh","journal-title":"J Pers Med"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1002\/wps.21183","article-title":"Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. a meta-analysis of 176 randomized controlled trials","volume":"23","author":"Linardon","journal-title":"World Psychiatry"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1177\/2055207620907187","article-title":"Physician attitudes towards\u2014and adoption of\u2014mobile health","volume":"6","author":"Kong","journal-title":"Digit Health"},{"issue":"3","key":"R15","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.hlpt.2017.07.007","article-title":"Investigation of physicians\u2019 awareness and use of mHealth apps: a mixed method study","volume":"6","author":"Sezgin","journal-title":"Health Policy Technol"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/48000","article-title":"Mapping factors that affect the uptake of digital therapeutics within health systems: scoping review","volume":"25","author":"van Kessel","journal-title":"J Med Internet Res"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1038\/s41746-023-00899-4","article-title":"Barriers and facilitators to utilizing digital health technologies by healthcare professionals","volume":"6","author":"Borges do Nascimento","journal-title":"NPJ Digit Med"},{"issue":"11","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/33012","article-title":"Physicians\u2019 attitudes toward prescribable mHealth apps and implications for adoption in Germany: mixed methods study","volume":"9","author":"Dahlhausen","journal-title":"JMIR Mhealth Uhealth"},{"key":"R19","unstructured":"Gordon N . Similarity of adult Kaiser Permanente members to the adult population in Kaiser Permanente\u2019s Northern California service area: comparisons based on the 2017\/2018 cycle of the California Health Interview Survey. Kaiser Permanente Division of Research. 2020. URL: https:\/\/memberhealthsurvey.kaiser.org\/Documents\/compare_kp_ncal_chis2017-18.pdf [Accessed 27-08-2024]"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.20.0295","article-title":"How Kaiser Permanente created a mental health and wellness digital ecosystem","volume":"2","author":"Mordecai","journal-title":"NEJM Catal"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1097\/EDE.0b013e3181577654","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"18","author":"von Elm","journal-title":"Epidemiology"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6.3.e34","article-title":"Improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES)","volume":"6","author":"Eysenbach","journal-title":"J Med Internet Res"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","journal-title":"J Chronic Dis"},{"issue":"9","key":"R24","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","journal-title":"J Gen Intern Med"},{"issue":"3","key":"R25","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population","volume":"46","author":"L\u00f6we","journal-title":"Med Care"},{"issue":"7","key":"R26","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s00127-015-1038-x","article-title":"The gender gap in mental health service use","volume":"50","author":"Pattyn","journal-title":"Soc Psychiatry Psychiatr Epidemiol"}],"container-title":["JMIR Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mental.jmir.org\/2024\/1\/e56574","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:45:42Z","timestamp":1782841542000},"score":1,"resource":{"primary":{"URL":"https:\/\/mental.jmir.org\/2024\/1\/e56574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,2]]},"references-count":26,"URL":"https:\/\/doi.org\/10.2196\/56574","relation":{},"ISSN":["2368-7959"],"issn-type":[{"value":"2368-7959","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,2]]},"article-number":"v11i8e56574"}}