A focus group study published in JMIR Aging highlights the need for digital health providers to enhance communication and trust-building efforts with older adult patients, particularly those managing musculoskeletal conditions. The findings suggest that, while digital health platforms offer several advantages for self management and physiotherapy, providers must address older adults’ scepticism about the quality, reliability, and safety of these technologies to ensure equal access to these benefits. The study, conducted by researchers from The University of Warwick, The University of Birmingham, and the digital musculoskeletal health company EQL, explored the experiences and perceptions of adults aged 60 and above regarding digital health platforms designed to support musculoskeletal care. Focus groups were conducted to gauge participants’ views on real-world examples of digital tools used for self-referral and physiotherapy exercises. Despite the growing use of digital platforms for health management, particularly since the COVID-19 pandemic, the findings reveal significant concerns among older adults about replacing face-to-face consultations with technology. Participants cited a lack of trust in digital platforms’ ability to accurately diagnose conditions or monitor physiotherapy exercises effectively without in-person oversight.
Key findings include concerns over trust and quality, with participants voicing scepticism about the accuracy and safety of digital health platforms. Some worried that serious conditions could be overlooked without in-person assessments. Many participants expressed a preference for hybrid models, combining digital tools with periodic face-to-face consultations, allowing patients to benefit from technology while ensuring healthcare professionals oversee their progress. The need for verification was another key issue, with participants calling for clearer indicators of app legitimacy, such as a certification or “kitemark” equivalent, to help distinguish between reliable health apps and unverified ones. The study also highlighted digital literacy barriers, with some older adults struggling to navigate digital platforms or feeling uncertain about how to use chatbots and other online tools effectively.
Key lessons for digital healthcare providers include recognizing that, while digital health technologies are becoming more widespread in managing musculoskeletal conditions, particularly as pressure on healthcare services increases, better education and communication are needed to build trust among older adults. The research team recommends raising public awareness about organizations that verify and assess the quality of digital health platforms, such as the Organisation for the Review of Care and Health Apps (ORCHA) in the UK. A focused communication campaign aimed at older adults could raise awareness of ORCHA, allowing potential users to quickly check whether apps have been reviewed and rated. Additionally, digital health companies should design user pathways with varying levels of digital literacy in mind, simplifying and user-testing their user interface (UI) in partnership with this demographic to effectively reduce barriers for older adults. Providers should also consider making periodic in-person care an option for users who would benefit from—or prefer—hybrid treatment. This could involve assisting with the booking process for face-to-face appointments and ensuring they are delivered alongside digital support.
“Digital health platforms for musculoskeletal conditions have also been shown to improve patient outcomes and, further, in terms of physiotherapy interventions, lead to better intervention adherence,” said study author Peter Grinbergs. “However, as our focus group participants’ responses illustrate, it is important to consider the accessibility and acceptance of such platforms for older adults, who are not part of the ‘digital native’ generation. To build and maintain the trust of this group, providers must prioritize transparent communication about the benefits and limitations of digital tools while ensuring these platforms complement the care provided by healthcare professionals.” This study offers valuable insights for healthcare providers and app developers aiming to improve older adults’ confidence in using digital health technologies. By fostering trust and enhancing usability, digital platforms can become more accessible and effective tools in managing health and promoting recovery.
