Developing digital therapeutics that are accepted by chronic patients. Unveiling the interplay between rational and institutional factors

The rising incidence of chronic diseases, also favored by climate change, is an urgent challenge for healthcare systems worldwide. In this context, Digital Therapeutics (DTx) represent an innovative, cost-effective, and evidence-based solution to prevent, manage and treat chronic diseases, accessible via smartphone or tablet apps. Among the various benefits, DTx might decrease CO2 emissions for the reduced need for physical displacements for life-lasting care while guaranteeing access also in cases of impediments to climate change. This study aims to design and test a theoretical model to investigate the diffusion of DTx among obese patients. The innovativeness of this research is represented by the novel integration of two diverse theories which have been rarely combined in past studies, namely the Technology Acceptance Model (TAM) and Institutional Theory. The DTx object of this study was designed to treat obesity and the model was tested through a survey relying on 331 responses from current and former obese patients of Auxologico Hospital. The hypothesized relationships were statistically validated, using the Structural Equation Modelling technique. The analyses showed some influence from the institutional factors on TAM constructs, i.e Perceived Ease of Use and Perceived Usefulness. Results can be insightful for institutions, such as Auxologico Hospital, willing to foster the diffusion of DTx. Indeed, patients can be encouraged to use DTx both by leveraging on the perceived usefulness and by providing instructions for guiding the patient during the usage.