Balancing innovation and safety: community perspectives on proximity and digital medical care

Abstract Introduction The rising prevalence of non-communicable diseases (NCDs), along with ongoing healthcare digitalization, is driving the shift toward proximity care models. These models aim to deliver care within patients’ living environments, enhancing personalization and sustainability. However, they also pose new challenges-especially regarding medication safety. The ProSafe study explored community perspectives on safety issues in proximity and digitalized care pathways. Methods The study followed a Community-Based Participatory Research framework. An online survey, co-designed with a Patient Safety Council, was conducted nationwide from May to October 2023. A total of 417 adults (81% with NCDs) participated. Data were analyzed using descriptive statistics, chi-square and t-tests, and Conditional Mixed Process models. Results Overall, 85.5% of respondents considered the shift from hospital-based to home-based therapy beneficial. However, 63.7% expressed concerns about feeling less supported, and 47% of patients anticipated a decline in the therapeutic alliance-significantly more than healthy individuals (32.9%, p < 0.01). Telehealth and digital tools were rated more positively by healthy respondents than patients (mean scores: 1.5 vs. 1.3, p < 0.01). Continuity-of-care issues were reported by 70.1% of participants, including difficulties accessing medications (52.3%) and lack of adequate safety information (38.6%). Acceptance of proximity and digital care was significantly associated with higher educational attainment (p < 0.05), better perceived health status (p < 0.01), and absence of oncological conditions, with cancer patients showing greater reluctance (p < 0.05). Conclusions Proximity and digital care models are broadly supported, but significant concerns remain regarding support, continuity, and autonomy. Strengthening communication, enhancing digital literacy, and fostering co-designed interventions are crucial to ensuring safe, equitable, and person-centred care. Key messages • Patients support proximity care but report concerns about reduced support and continuity, highlighting the need for person-centred strategies to ensure safety in digital healthcare. • Acceptance of digital and proximity care varies by health status and education, stressing the importance of inclusive, co-designed models to foster trust and engagement in medication management.