Background: The rapid expansion of mobile health (mHealth) apps has transformed health care 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 apps 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 factors influencing these behaviors for the usage of mHealth apps among people living with epilepsy in Pakistan.
Methods: We conducted a cross-sectional analytical survey between March and July 2024 among people living with epilepsy attending the Pakistan Institute of Medical Sciences (PIMS). Participants completed a validated, self-administered questionnaire with 33 items across 5 domains. We recruited 406 participants through convenience sampling and analyzed the data using SPSS version 23.0 (IBM Corp). Through multivariable linear regression analysis, we explored factors associated with people living with epilepsy willingness to use mHealth apps. Correlation analysis was used to elucidate the association among awareness, perception, feasibility, and willingness.
Results: Among 406 participants, 53.7% (n=218) were male, 64.5% (n=262) were married, and 89.2% (n=362) were identified as Muslim. Although 86.2% (n=350) of participants have heard about mHealth apps for epilepsy management, 78.1% (n=317) expressed negative perceptions of their use. More than half, 69% (n=280), reported concerns about the privacy of their medical information online, and 78.1% (n=317) were not comfortable using mHealth apps on smartphones or tablets. Multivariable linear regression analysis revealed that rural residents (P=.05), 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 (ρ=-0.124; P=.01) and a weak positive relationship between awareness and willingness (ρ=0.013; P=.07).
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, nongovernmental organizations, academia, and health care providers can improve education, enhance data security, and adapt mHealth tools to local needs, ultimately improving treatment access and outcomes for people living with epilepsy.
Keywords: cross-sectional study; digital tool; epilepsy; feasibility; mobile health apps; treatment compliance.
©Bushra Batool Zahra, Muhammad Amir Hamza, Rehana Sarwat, Hina Batool Zahra, Ayesha Azam, Ali Ahmed. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.12.2025.