Integrating Digital Health Applications for Mental Disorders (DHA-MDs) into Routine Care: From Efficacy to Effectiveness, Personalised Indication, and Integrated Care

Digital Health Applications (DHAs, known as DiGAs in Germany) represent a paradigm shift in mental healthcare, allowing medical practitioners and psychotherapists to prescribe digital therapeutics covered by statutory health insurance. While these technologies promise to bridge treatment gaps and reduce waiting times for psychotherapy, actual clinical adoption remains lower than expected, and most existing evidence on DHA-MD efficacy comes from randomized controlled trials (RCTs) conducted under controlled conditions with selected populations.RCT efficacy does not guarantee real-world effectiveness: routine care populations are more heterogeneous, indication is still largely diagnosis-based rather than tailored to the patient, and DHA-MDs are mostly used as stand-alone tools rather than integrated into broader care pathways. This Research Topic follows Dr. Stalujanis’ proposed storyline, moving from efficacy to effectiveness, from diagnosis to personalised indication, and from stand-alone interventions to integrated care, to give the collection a single, distinct health-services-research perspective rather than a set of parallel, loosely related themes.This Research Topic will collect cutting-edge empirical research, systematic reviews, and policy perspectives addressing how DHA-MDs perform, for whom they work, and how they should be embedded in care, from a multi-stakeholder perspective (patients, psychotherapists, general practitioners, and insurers). It aims to:• Generate and synthesise real-world effectiveness evidence for DHA-MDs in routine care, benchmarked against RCT efficacy data.• Identify the patient-, condition-, and context-level factors that should inform a move from diagnosis-based prescription to personalised indication.• Establish evidence and models for integrating DHA-MDs into face-to-face psychotherapy and broader care pathways, rather than deploying them as stand-alone tools.Key Themes & Scope for Authors1. From Efficacy to Real-World Effectiveness: How well do effects demonstrated in RCTs translate into routine care, including differences in outcomes, adherence, and dropout?• Studies comparing DHA-MD outcomes under routine care against RCT efficacy benchmarks (symptom outcomes, adherence, dropout).• Use of registry, claims, or cohort data to evaluate real-world effectiveness outside controlled trial settings.• Real-world health economic evaluation: cost-effectiveness, cost reduction, and resource utilisation alongside trial-based cost estimates.2. From Diagnosis-Based Prescription to Personalised Indication: For which patients are DiGAs effective and suitable, and for whom are they not? Indication is currently largely diagnosis-based; this theme asks what else should determine it.• Symptom severity, comorbidity, previous treatment experience, concurrent treatment, patient preference, and digital competencies as indication factors.• Non-response, negative effects, and the potential limits of digital treatment.• Prescribing behaviours and clinician attitudes: what drives therapists’ and GPs’ willingness (or reluctance) to match a given patient to a digital intervention.• Digital placebo and efficacy expectancies: how patient expectations and the digital therapeutic alliance shape who benefits, framed as an indication and outcome question rather than a psychotherapy-process one.• Special populations and equity: DHA-MD suitability for cohorts such as adolescents, older adults, or rural populations with limited care access.3. From Stand-Alone Interventions to Integrated Care: How can DiGAs be meaningfully integrated into face-to-face psychotherapy and broader care pathways before, during, or after psychotherapy, as blended care, or within stepped-care approaches?• Application of implementation science frameworks (e.g., RE-AIM) to evaluate how DHA-MDs function within everyday clinical workflows.• Organisational and workflow barriers to embedding DHA-MDs alongside existing services.• Models and evidence for blended and stepped care combining digital and face-to-face treatment.Dr. Anna-Carlotta Zarski receives royalties for digital health application (DiGA) for sexual dysfunction implemented in routine care in Germany. She has received fees for delivering presentations at scientific conferences and for producing expert videos for a DiGA. The other Topic Editors report no competing interests related to this Research Topic. Topic editors: Esther Stalujanis, Johanna Schuller (born Löchner), Ann-Katrin Job, Anna-Carlotta Zarski Source: https://www.frontiersin.org/research-topics/86504/integrating-digital-health-applications-for-mental-disorders-dha-mds-into-routine-care-from-efficacy-to-effectiveness-personalised-indication-and-integrated-care