From scepticism to integration: adoption of mobile health apps in Danish chiropractic practice-a mixed methods study

Musculoskeletal (MSK) pain affects quality of life and burdens healthcare systems, increasing the need for effective self-management tools. Mobile health apps offer a potential solution, but their adoption in clinical practice remains limited due to concerns about usability, patient engagement, and data security. Denmark is highly digitalized, with various digital health initiatives already in place. However, little is known about chiropractors' engagement with health apps. This study examines how Danish chiropractors utilize and perceive health apps in their practice, identifying key barriers and facilitators to adoption and providing insights for broader implementation in primary care settings to improve self-management support for patients with MSK pain.

A two-staged sequential mixed-methods exploratory study was conducted, comprising a quantitative survey distributed to active members of the Danish Chiropractic Association in June 2022 followed by 11 qualitative semi-structured interviews with a purposively sampled subset of respondents, conducted from November 2022 to May 2023. The quantitative data were analysed for frequencies and proportions, while qualitative data were analysed using framework analysis. Integration of both datasets was performed to identify patterns and insights.

Out of 650 chiropractors, 294 (45%) responded to the survey, with 288 included in the analysis. The results indicated that while over half of the chiropractors used health apps personally, only 15% utilized them in patient care. Key barriers included limited knowledge, time constraints, and narrow scope of use, while facilitators included app user-friendliness and positive patient feedback. Qualitative insights revealed varied attitudes towards mHealth, with some chiropractors perceiving apps as valuable tools for patient support, while others expressed scepticism regarding their relevance and effectiveness.

This study provides valuable insights into the current state of health app integration within Danish chiropractic practice, highlighting the need for targeted education and policy changes to facilitate the adoption of digital health tools. It emphasizes the importance of addressing both patient and provider perspectives to enhance self-management strategies for MSK pain through mHealth solutions. The findings contribute to the broader discourse on digital health integration in healthcare, particularly within the chiropractic profession.