The use of eHealth in primary physiotherapy care: a mixed-method study.

Abstract

To explore how Danish physiotherapists use eHealth modalities in musculoskeletal primary care and to identify perceived barriers and facilitators to their implementation. A mixed-methods study using a sequential explanatory design was conducted, comprising a national online survey followed by semi-structured interviews. The survey assessed the use, frequency, and perceived facilitators and barriers related to eHealth modalities, while interviews explored underlying attitudes and experiences. In total, 121 primary care physiotherapists completed the survey, and nine participated in follow-up interviews. Survey results showed that basic digital tools, such as email and telephone communication, were commonly used, whereas more advanced technologies were rarely adopted. Reported barriers included patients' technological skills, age-related concerns, and physiotherapists' confidence in delivering digital care, while flexibility and patients' digital competence were identified as key facilitators. Thematic analysis of interviews revealed five themes: patient and therapist-related factors, flexibility, practical considerations, patient-centered care, and future implementation. Overall, the findings indicated ambivalence toward digital care despite positive attitudes. Although eHealth offers opportunities to support flexible and self-managed care in musculoskeletal rehabilitation, its integration into primary care physiotherapy remains limited. Addressing technical and professional barriers is essential for digital care in disability and rehabilitation.