Sandra Salm

Purpose: General practitioners (GPs) are central to the lifelong care of cancer survivors, yet it remains unclear which information needs they have regarding the content and format of oncological medical reports. This study explores which information GPs require and how they interpret and use this information to provide long-term cancer care in the context of German primary care. Methods: We conducted an exploratory qualitative study using a multi-method approach: semi-structured interviews with 14 GPs, a think-aloud interview with an oncologist during report drafting, and a workshop with six GPs and one oncologist. Data were analyzed using a content-based summarizing approach. Results: GPs emphasized that information on performed treatments, current diagnostic findings (including excluded diagnoses), and the specific information shared with the long-term cancer survivor are highly relevant. To effectively implement the information from medical reports in care provision, prioritized risks of late effects, and clear recommendations for further care are needed. Structured presentation of information, such as bullet points or tables, was perceived as supporting interpretation and use of information. Conclusions: Structured and prioritized medical reports support GPs in their role as coordinators and providers of long-term cancer care. Such reports have the potential to improve the continuity and quality of care for long-term cancer survivors by bridging oncology and primary care. Implications for Cancer Survivors: Survivors benefit from better-informed GPs who can provide consistent counseling and management of long-term and late effects. Clearer communication between other specialists and GPs reduces the risk of fragmented care and ensures that long-term survivorship needs are addressed holistically within the primary care setting.

Background: In Germany, the guideline-compliant provision of psycho-oncological care is challenging. To improve care structures, a newly developed psycho-oncological care programme ‘integrated cross-sectoral Psycho-oncology’ (isPO) was implemented in four psycho-oncological care networks and externally evaluated for quality of care (QoC) and effectiveness. The psycho-oncological service providers’ (SP) perspective was assessed as part of the QoC evaluation. Methods: A mixed methods design with quantitative and qualitative methods was used. SPs were surveyed twice after programme implementation. They rated their programme satisfaction and contextual and individual factors that might affect its implementation. Medical staff from oncological wards were surveyed once after implementation. Descriptive and correlation analyses were conducted. The independent samples t -test was used to compare programme assessment between medical staff and SPs. Semi-structured interviews were conducted with the head psycho-oncologists and two cross-network focus groups with SPs from different professions. One semi-structured interview was conducted for someone who could not attend the focus group. Purposeful sampling was used. All interviews and focus groups were audiotaped, transcribed, and analysed using content-structuring method. Results: In the surveys, SPs rated their programme acceptance and the care concept positively. Most stated that QoC and cross-sectoral care had improved due to isPO. In the interviews and focus groups, patient benefits were described as the main factors facilitating programme acceptance. Therefore, needs orientation was crucial for structured diagnostics, care intensity, and flexibility in appointment frequencies. Having a fixed contact person across sectorial boundaries was identified as highly beneficial. Organisational workload determinants, such as documentation and bureaucracy, were critically reflected upon as hindering implementation and straining. Participation in quality management activities was perceived as helpful in discussing ways of tailoring the programme to the practice, thereby improving its feasibility. Conclusions: SPs’ programme assessment and experience help indicate the programme’s feasibility and possible fit for routine care. Including participatory elements in the implementation or development phase may support adapting the programme to an implementation site’s needs. SPs’ experience with the stepped and needs-centred care approach indicates that its underlying concept is recommendable for routine care. However, persistent programme optimisations should be enabled and further implemented within structured quality management. Trial registration: The study was registered in the German Clinical Trials Register (No. DRKS00015326) on 30 October 2018.

DNVF Memorandum Partizipative Versorgungsforschung (Teil 1) Anna Levke Brütt, Sandra Borgmann, Eva Buchholz et al. Gesundheitswesen; 10.1055/a-2665-0028 Im oben genannten Artikel wurden mehrere Fehler in den Affiliationen 12, 13, 25 und 26 korrigiert. Die korrekten Affiliationen lauten: 12 BRCA-Netzwerk e.V. – Hilfe bei familiären Krebserkrankungen, Bonn, Germany 13 partieval – Vermittlung partizipativer Kompetenzen, Prozessbegleitung und Evaluation im Bereich Gesundheit GmbH, Aachen, Germany 25 Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V., Hannover, Germany 26 MS Forschungs- und Projektentwicklungs-gGmbH, Deutsches MS-Register, Hannover, Germany Die Korrektur wurde in der Online-Version ausgeführt am 18.02.2026. Article published online: 18 February 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/). Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Background: The high number of mental disorders poses challenges for health care systems. In 2020, digital health applications (DHAs) were introduced in Germany as a new form of health care financed by the statutory health insurance. They aim to detect, monitor, treat, or alleviate disease, injury, or disability. DHAs for mental disorders (DHA-MD) intend to improve outpatient care for patients with mental disorders. However, evidence on general practitioners’ (GPs’) perspectives on DHA-MD and their prescribing behavior is limited. Objective: This study aimed to analyze GPs’ perspectives on DHA-MD and their prescribing behavior in the care of patients with mental disorders. Methods: A mixed methods study was conducted (January-October 2024), including a Germany-wide online survey and qualitative interviews with GPs and medical assistants (MAs). Sampling was conducted in collaboration with German research practice networks, which distributed the study invitation to their affiliated GPs. The questionnaire as well as the interview guides for GPs and MAs was developed by the study team according to the Consolidated Framework for Implementation Research. Descriptive analyses of prescribing behavior and perceived need (measured on an 11-point scale) for DHA-MD were conducted, followed by multivariate regression analyses to identify predictors of prescribing behavior and perceived need for DHA-MD. The interviews with GPs and MAs were analyzed using qualitative content analysis according to Mayring. Results: A sample of 149 GPs participated, and 12 GPs as well as 5 MAs were interviewed. The median prescription frequency of DHA-MD per quarter was 1, whereas the median estimated need was 3. Working in a half digitized and half paper-based practice (odds ratio 5.133, 95% CI 1.695‐15.542) as well as working in a completely digitized practice (odds ratio 3.006, 95% CI 1.296‐6.969) positively predicted the prescribing behavior. The duration of GPs’ medical practice ( b =−0.057; P =.01) negatively predicted the perceived need, while working in a group practice ( b =0.980; P =.02) positively predicted the perceived need for DHA-MD. In the interviews, GPs and MAs reported that they valued DHA-MD as a temporary or supplementary option for bridging waiting times for psychotherapy and considered their effectiveness to be highly dependent on indication and patient adherence. Reported barriers of GPs according to DHA-MD included lacking knowledge about DHA-MD, missing effectiveness studies, and difficulties integrating them into existing care processes. Conclusions: GPs are reluctant to prescribe DHA-MD, as the need is considered to be low and their use is primarily seen as a temporary or supplementary treatment option rather than a stand-alone intervention. There are significant reasons for rejection and barriers that hinder prescription in primary care. Addressing these barriers and involving GPs as well as patients in future research are essential for the development of DHA-MD.

Background: Since 2020, psychotherapists in Germany have been allowed to prescribe digital health applications for mental disorders (DHA-MDs). DHA-MDs were supposed to foster digitalization and improve access to mental health services. However, prescriptions of DHA-MDs are less frequent than expected. Objective: We aimed to investigate which characteristics of psychotherapists predicted perceived need for and prescribing of DHA-MDs among German psychotherapists. Methods: This study was a cross-sectional survey conducted in Germany. We contacted psychotherapists between January 2024 and April 2024 via professional associations, training institutes, or the social media platform X (formerly known as Twitter). We sent questionnaires to 1000 psychotherapy practices randomly selected from the registry of the National Association of Statutory Health Insurance Physicians. We assessed the characteristics of the psychotherapists, asked them to rate the perceived need for DHA-MDs on an 11-point scale, and documented their prescribing behavior. Linear and logistic regression analyses were performed to predict perceived need and prescribing, respectively. Results: A total of 321 psychotherapists participated. Perceived need was estimated as low (mean 2.1, SD 2.1). Among the 271 (84.4%) psychotherapists with valid data, 83 (30.6%) prescribed a DHA-MD to at least 1 patient in a regular quarter. As compared to a behavioral approach, a psychodynamic (b=–1.63; P<.001) or systemic psychotherapy approach (b=–1.48; P=.005) and higher age (b=–0.03; P=.007) negatively predicted the perceived need, while being a physician (vs psychologist; b=0.73; P=.02) and a psychotherapeutic and psychopharmacological treatment focus (vs psychotherapeutic alone; b=1.31; P=.04) positively predicted the perceived need. For prescribing DHA-MDs, odds were lower for psychotherapists with a psychodynamic, systemic, or other approach (vs behavioral approach; odds ratio [OR] 0.30, 95% CI 0.14-0.64). The odds were higher for psychotherapists with more than a half service mandate (vs less than or equal to a half service mandate; OR 2.99, 95% CI 1.50-5.97), working in a group practice or medical care center (vs single practice; OR 2.39, 95% CI 1.04-5.53), and being located in a rural community or small town (OR 2.74, 95% CI 1.27-5.94) or a medium-sized town (OR 2.67, 95% CI 1.21-5.92) compared to a large city. Conclusions: Professional group, psychotherapy approach, age, the size of service mandate, treatment focus, practice type, and community size predicted perceived need for and prescribing of DHA-MDs among psychotherapists. Our findings may inform stakeholders and decision-makers in health care and politics about where DHA-MDs have already been implemented in the landscape of mental health services.

Zusammenfassung: Patient:innen als zentrale Akteur:innen der Gesundheitsversorgung sollen sich aktiv in Versorgungsforschungsprozesse einbringen können. Auch weitere Stakeholder – etwa Fachkräfte aus der Versorgungspraxis – sind für einen umfassenden partizipativen Ansatz von Bedeutung. In diesem DNVF Memorandum stehen partizipative Ansätze im Kontext der Versorgungsforschung im Mittelpunkt. Zunächst werden die Charakteristika partizipativer Versorgungsforschung beschrieben und ihr Entwicklungsstand sowie ihre Institutionalisierung in Deutschland dargestellt. Dabei werden auch das Potenzial und die Vorteile partizipativer Versorgungsforschung beleuchtet. Schließlich widmet sich das DNVF Memorandum zwei Querschnittsthemen, die für die Weiterentwicklung besonders relevant sind: der theoretisch-konzeptionellen Fundierung sowie der Erforschung von Effekten und Wirksamkeit partizipativer Ansätze.

Zusammenfassung: Theoretischer Hintergrund: Der Einsatz Digitaler Gesundheitsanwendungen für psychische Erkrankungen (PsyDiGA) wird kontrovers diskutiert. Fragestellung: Für wen und in welchem Behandlungskontext sind PsyDiGA (nicht) geeignet? Methode: Bundesweit niedergelassene Psychotherapeut_innen erhielten einen Fragebogen, der stratifiziert nach Verschreibungserfahrung mit PsyDiGA ausgewertet wurde. Zusätzlich analysierten wir leitfadenbasierte Interviews mittels qualitativer Inhaltsanalyse. Ergebnisse: Es lagen 321 Fragebögen sowie 16 Interviews vor. PsyDiGA seien geeignet für Patient_innen mit eingeschränkter Mobilität und ungeeignet bei Personen älter als 65 Jahre. Die Befragten lehnten PsyDiGA als primäre Behandlungsmethode ab, während dem Einsatz zur Überbrückung von Wartezeiten mehrheitlich zugestimmt wurde. Psychotherapeut_innen mit und ohne Verschreibungserfahrung von PsyDiGA unterschieden sich zum Teil deutlich hinsichtlich ihres Antwortverhaltens. Aus den Interviews ergaben sich die Notwendigkeit von persönlichem Kontakt, die Berücksichtigung psychischer Belastung sowie Technikaffinität als Kriterien für (fehlende) Eignung. Schlussfolgerungen: Die Verschreibung von PsyDiGA scheint abhängig von der therapeutischen Orientierung sowie der Abwägung zwischen Notwendigkeit und Möglichkeiten zu persönlicher Kontaktaufnahme zu sein.

BACKGROUND The high number of mental disorders poses challenges for healthcare systems. In 2020, digital health applications (DHA) were introduced in Germany as a new form of healthcare financed by the statutory health insurance. They aim to detect, monitor, treat, or alleviate disease, injury, or disability. DHA for mental disorders (DHA-MD) intend to improve outpatient care for patients with mental disorders. However, evidence on general practitioners (GP) perspectives on DHA-MD and their prescribing behavior is limited. OBJECTIVE The aim of this study was to analyze GPs’ perspectives on DHA-MD and their prescribing behavior in the care of patients with mental disorders. METHODS A mixed methods study was conducted (January - October 2024), including a Germany-wide online survey and qualitative interviews with GPs and medical assistants (MA). Sampling was conducted in collaboration with German research practice networks, which distributed the study invitation to their affiliated GPs. The questionnaire as well as the interview guides for GPs and MAs were developed by the study team according to the Consolidated Framework for Implementation Research. Descriptive analyses of prescribing behavior and perceived need (measured on an 11-point scale) for DHA-MD were conducted, followed by multivariate regression analyses to identify predictors of prescribing behavior and perceived need for DHA-MD. The interviews with GPs and MAs were analyzed using qualitative content analysis according to Mayring. RESULTS A sample of 149 GPs participated, 12 GPs and 5 MA were interviewed. The median prescription frequency of DHA-MD per quarter was 1 whereas the median estimated need was 3. Working in a half digitized/half paper-based practice (OR = 5.133, 95% CI [1.695 – 15.542]) as well as working in a completely digitized practice (OR = 3.006, 95% CI [1.296 - 6.969]) positively predicted the prescribing behavior. The duration of GPs’ medical practice (b = -.057, P = .013) negatively predicted the perceived need, while working in a group practice (b = .980, P = .02) positively predicted the perceived need for DHA-MD. In the interviews, GPs and MAs reported they valued DHA-MD as a temporary or supplementary option for bridging waiting times for psychotherapy and considered their effectiveness to be highly dependent on indication and patient adherence. Reported barriers of GPs according to DHA-MD included lacking knowledge about DHA-MD, missing effectiveness studies, and difficulties integrating them into existing care processes. CONCLUSIONS GPs are reluctant to prescribe DHA-MD, as the need is considered to be low and their use is primarily seen as a temporary or supplementary treatment option rather than a standalone intervention. There are significant reasons for rejection and barriers that hinder prescription in primary care. Addressing these barriers and involving GPs as well as patients in future research is essential for the development of DHA-MD.

BACKGROUND Since 2020, psychotherapists in Germany have been allowed to prescribe digital health applications for mental disorders (DHA-MDs). DHA-MDs were supposed to foster digitalization and improve access to mental health services. However, prescriptions of DHA-MDs are less frequent than expected. OBJECTIVE We aimed to investigate which characteristics of psychotherapists predicted perceived need for and prescribing of DHA-MDs among German psychotherapists. METHODS This study was a cross-sectional survey conducted in Germany. We contacted psychotherapists between January 2024 and April 2024 via professional associations, training institutes, or the social media platform X (formerly known as Twitter). We sent questionnaires to 1000 psychotherapy practices randomly selected from the registry of the National Association of Statutory Health Insurance Physicians. We assessed the characteristics of the psychotherapists, asked them to rate the perceived need for DHA-MDs on an 11-point scale, and documented their prescribing behavior. Linear and logistic regression analyses were performed to predict perceived need and prescribing, respectively. RESULTS A total of 321 psychotherapists participated. Perceived need was estimated as low (mean 2.1, SD 2.1). Among the 271 (84.4%) psychotherapists with valid data, 83 (30.6%) prescribed a DHA-MD to at least 1 patient in a regular quarter. As compared to a behavioral approach, a psychodynamic (b=–1.63; P<.001) or systemic psychotherapy approach (b=–1.48; P=.005) and higher age (b=–0.03; P=.007) negatively predicted the perceived need, while being a physician (vs psychologist; b=0.73; P=.02) and a psychotherapeutic and psychopharmacological treatment focus (vs psychotherapeutic alone; b=1.31; P=.04) positively predicted the perceived need. For prescribing DHA-MDs, odds were lower for psychotherapists with a psychodynamic, systemic, or other approach (vs behavioral approach; odds ratio [OR] 0.30, 95% CI 0.14-0.64). The odds were higher for psychotherapists with more than a half service mandate (vs less than or equal to a half service mandate; OR 2.99, 95% CI 1.50-5.97), working in a group practice or medical care center (vs single practice; OR 2.39, 95% CI 1.04-5.53), and being located in a rural community or small town (OR 2.74, 95% CI 1.27-5.94) or a medium-sized town (OR 2.67, 95% CI 1.21-5.92) compared to a large city. CONCLUSIONS Professional group, psychotherapy approach, age, the size of service mandate, treatment focus, practice type, and community size predicted perceived need for and prescribing of DHA-MDs among psychotherapists. Our findings may inform stakeholders and decision-makers in health care and politics about where DHA-MDs have already been implemented in the landscape of mental health services. CLINICALTRIAL