JMIR Publications

ABSTRACT

Background:

Digital health technology is increasingly applied across neurological conditions and is now widely accessible from both individual and formal healthcare perspectives. Nevertheless, comprehensive evidence on attitudes towards digital health technology in this population remains limited.

Objective:

This study aimed to investigate attitudes towards digital health technology from the perspectives of people living with neurological conditions, carers, and healthcare professionals.

Methods:

An in-depth qualitative design was employed, using semi-structured interviews with 35 participants (15 people with neurological conditions, 13 carers, 7 healthcare professionals) across multiple neurological conditions. Inductive thematic analysis, guided by a realist approach, was applied separately to each participant group.

Results:

Five themes emerged across all three groups: (1) openness to use; (2) digital literacy, experience, and ability to use; (3) hesitancy, uncertainty, and perception of benefit; (4) user age and access to technology; and (5) continued need for access to healthcare professionals. Participants were generally open to digital health technology but reported important caveats, including variable digital literacy, uncertainty about benefit, concerns about age-related access, and a persistent preference for in-person clinical contact. Three findings were particularly significant. First, most participants across all three groups were unaware of what digital health tools were available for their neurological condition. Second, neurological symptoms themselves, including fatigue, cognitive impairment, tremor, and photosensitivity, were identified as barriers to technology use that are distinct from, and additional to, the digital literacy barriers documented in the general population. Third, a cross-group comparison revealed that whilst attitudes were broadly shared, each group evaluated digital health technology from a different perspective: people living with neurological conditions considered it in relation to personal utility and condition-relevance; carers in relation to reliability and the ability to escalate concerns; and healthcare professionals in relation to evidence base and service capacity.

Conclusions:

Most participants were open to the uptake and use of digital health technology. The awareness gap and the neurological symptom barrier represent findings with immediate relevance to practice. Active promotion of available, evidence-based digital health tools directed simultaneously at people living with neurological conditions, carers, and healthcare professionals is a prerequisite for meaningful engagement. Digital health tools should be co-designed to account for the specific symptom profiles of people living with neurological conditions and should complement rather than replace in-person care relationships. Implementation strategies should engage all three stakeholder groups simultaneously, as meeting the needs of one does not guarantee meeting the needs of another.