# Sustainable assessment in digital health interventions for primary care: A scoping review

## TL;DR

This scoping review explores how digital health interventions in primary care are evaluated for sustainability across financial, social, and environmental aspects.

## Contribution

The study provides a structured framework for assessing sustainability in digital health interventions within primary care.

## Key findings

- DHIs should focus on health promotion, prevention, and user adherence while managing clinical risks.
- Social aspects like inclusion, data protection, and empowerment are critical for successful implementation.
- Financial and environmental sustainability requires efficient resource use and reduced emissions.

## Abstract

Primary care is essential for improving healthcare access and global health, yet it faces challenges related to limited capacity and slow response times. Digital health interventions (DHI) (DHIs) are increasingly used to address these gaps by promoting healthy behaviours, patient empowerment, and health literacy. However, their implementation is challenged by insufficient regulations and infrastructure, and evaluations often overlook broader sustainability concerns. This scoping review examines how DHIs in primary care are assessed for sustainability across financial, social, and environmental domains.

The scoping review methodology consisted of three stages: pearl-growing, keywords with operators, and reference list search. MEDLINE (PubMed and Ovid), CINAHL, IEEE Access, ScienceDirect, NICE, and TRIP databases were utilised, and the results were evaluated using qualitative content analysis.

The review highlights four aspects to consider when implementing digital health interventions: Enhancing health promotion and illness prevention through the user’s adherence to treatment, while addressing clinical risks. Examine social implications considering wellbeing, access, inclusion, participation, empowerment, and data protection. Consider financial impacts such as resource management, available funding, and appropriate infrastructure. And environmental implications that include product life cycle, resource use, and greenhouse emissions.

It is recommended that guidelines for implementing DHIs in primary care prioritise improving health promotion and preventive care. Emphasising the value of building public trust by promoting well-being, ensuring human rights in data governance, addressing social determinants of health, and improving resource efficiency through interoperability and circular economy principles.