General practitioners' perspectives on implementing a self-management mobile application for musculoskeletal pain

Musculoskeletal conditions are common, and digital self-management tools are increasingly used to support general practice. General practitioners' perceptions of digital tools are key to implementation.

To interpret how general practitioners (GPs) perceive and implement a self-management exercise app for musculoskeletal pain in general practice.

Qualitative study using semi-structured interviews with nine Danish GPs.

Data were analysed using reflexive thematic analysis, enabling an iterative and interpretive engagement. Themes were developed abductively informed by the Theoretical Domains Framework, which was used as an analytical lens. The analysis explored how GPs perceived the clinical value and usability of the app, focusing on factors influencing implementation.

GPs use of the app was influenced by the perceived compatibility with clinical workflow and clinical responsibility. Facilitators included trust in the app's quality, user-friendliness, and peer endorsement. The app was perceived as useful in remote or financially limited settings. Barriers included increased workload, limited time and familiarity. Implementation was shaped by time pressures and intuitive judgements of patients' digital literacy and adherence to exercise. The app was used as a supplementary tool, and implementation reflected pragmatic clinical reasoning rather than system-level objectives.

Successful implementation of mHealth tools depends not only on usability but also on GPs' confidence in the quality and clinical value of the solution. A clearly defined purpose aligned with system-level objectives is essential for embedding mHealth tools as an alternative in routine care pathways rather than leaving their use to individual clinical purpose and judgement.