Abstract:
Despite the growing availability of clinically validated digital therapeutics (DTx), their prescription rates remain low. Physicians act as essential gatekeepers in ensuring patients’ access to these innovations, yet little is known about how they decide whether or to whom to prescribe DTx. This study explores the factors shaping physicians’ decisions to prescribe DTx. Drawing on the theory of reasoned action (TRA), we conducted semi-structured interviews with 20 German physicians. We identify three dimensions that influence prescription intentions: subjective norms, physicians’ attitudes toward DTx, and a newly uncovered construct, ‘perceived patient attitude’, which reflects physicians’ assessments of patients’ expected self-efficacy, adherence, and adoption. Our findings extend TRA by integrating perceived patient attitude as a moderating factor, emphasizing physicians’ gatekeeping role in DTx prescription. The study contributes to theory by expanding behavioral models in healthcare contexts and to practice by informing strategies that enhance physician engagement and patient readiness for DTx.