- Evidence on DTx use burden for chronic disease patients is preliminary, with no studies directly measuring patients' subjective burden and reliance on indirect indicators.
- Five potential burden sources identified: digital access, data recording, task completion, continuous use, and technical operation burdens affecting engagement and adherence.
- Future research should combine patient-reported burden with objective usage data and discontinuation reasons; incorporate burden outcomes into implementation and policy evaluation.
Front Public Health. 2026 Aug 12;14:1919598. doi: 10.3389/fpubh.2026.1919598. eCollection 2026.
ABSTRACT
OBJECTIVE: To systematically map the available evidence on the potential use burden of digital therapeutics (DTx) and DTx-related therapeutic digital interventions in patients with chronic diseases and to inform clinical implementation and policy evaluation.
METHODS: PubMed, Web of Science (WOS), Cochrane Library, Embase, Wiley, Scopus, CNKI, WanFang Data, VIP, and SinoMed databases were searched from inception to April 28, 2026. Studies were screened according to the inclusion and exclusion criteria. Data were extracted on application areas, potential sources of DTx use burden, indirect burden-related evaluation indicators, and support strategies potentially relevant to reducing DTx use burden.
RESULTS: A total of 11 studies were included. DTx and DTx-related therapeutic digital interventions for patients with chronic diseases were mainly applied in diabetes, hypertension, coronary heart disease, chronic insomnia, cancer treatment support, and inflammatory bowel disease. None of the included studies used a dedicated instrument to directly measure DTx use burden. Instead, burden-related evidence was mainly derived from indirect indicators, including utilization and participation indicators, module and task completion indicators, data recording indicators, acceptability and satisfaction indicators, and technical problems and safety records. The task requirements, use difficulties, and indirect indicators reported in the included studies suggested five potential sources of DTx use burden: digital access burden, data recording burden, task completion burden, continuous use burden, and technical operation burden.
CONCLUSION: Evidence on DTx use burden in patients with chronic diseases remains preliminary, and direct measurement of patients’ subjective DTx use burden is limited. Future studies should combine patient-reported DTx use burden with objective usage data and documented reasons for discontinuation, and incorporate burden-related outcomes into implementation and policy evaluation to improve accessibility, continuity of use, equity, and implementation sustainability.
PMID:42656885 | PMC:PMC13506955 | DOI:10.3389/fpubh.2026.1919598
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