JMIR Publications

ABSTRACT

Background:

The rapid expansion of mobile health (mHealth) applications has transformed healthcare delivery worldwide. Despite their potential to improve epilepsy care, a substantial treatment gap remains, especially in low- and middle-income countries, due to limited resources, stigma, and low adoption of digital technologies. Although mHealth applications can bridge these disparities, their impact depends on acceptance and use by the target population.

Objective:

We aimed to assess the awareness, feasibility, willingness, perception, and the factors influencing these behaviors for the utilization of mHealth applications among people living with epilepsy (PLWE) in Pakistan.

Methods:

We conducted a cross-sectional analytical survey between March and July 2024 among PLWE attending the Pakistan Institute of Medical Sciences (PIMS). Participants completed a validated, self-administered questionnaire with 33 items across five domains. We recruited 406 participants through convenience sampling and analyzed the data using SPSS version 23.0. Through multivariable linear regression analysis, we explored factors associated with PLWE willingness to use mHealth applications. Correlation analysis was employed to elucidate the association among awareness, perception, feasibility, and willingness.

Results:

Among 406 participants, 53.7% (218/406) were male, 64.5% (262/406) were married, and 89.2% (362/406) identified as Muslim. Although 86.2% (350/406) of participants have heard about mHealth applications for epilepsy management, 78.1% (317/406) expressed negative perceptions of their use. More than half, 69.0% (280/406), reported concerns about the privacy of their medical information online, and 78.1% (317/406) were not comfortable using mHealth applications on smartphones or tablets. Multivariable linear regression analysis revealed that rural residents (P<.054), those with a college education (P<.001), and participants with a treatment duration of 2-3 years (P<.001) significantly influenced participants' willingness. Correlation analysis showed a weak negative relationship between awareness and feasibility (r= -0.124, P˂.012) and a weak positive relationship between awareness and willingness (r = 0.013, P˂.070).

Conclusions:

To expand mHealth use for epilepsy care in Pakistan, stakeholders must address concerns about digital literacy, data privacy, and trust. Collaborative efforts involving government, technologists, non-governmental organizations, academia, and healthcare providers can improve education, enhance data security, and adapt mHealth tools to local needs, ultimately improving treatment access and outcomes for PLWE. Clinical Trial: Trial registration number not applicable.