Review Article

Evaluation of M-Health Applications Use in Epilepsy: A Systematic Review


Background: Epilepsy is a neurological disorder characterized by seizures and recurrent attacks. Self-management leads to seizure control and maximizes the quality of life in epileptic patients. The purpose of this study was to evaluate the quality of applications available in the epileptic google play store based on the rating features of MARS (Mobile Applications Rating Scale).

Methods: The search was conducted systematically using the keywords "epilepsy", "seizure", "mobile health" at the Android google play store. Data were extracted and analyzed from Feb 2018 to Apr 2019.

Results: Accordingly, 45 apps were identified potentially relevant of which 20 met inclusion criteria. Twenty-five apps were excluded because they were unrelated to epilepsy self-management, or not Development for people with epilepsy, not in English language or were not free and available. The total mean MARS score was 3.21 out of 5, and more than half of apps (17, 85%) had a minimum acceptability score of 3.0. The mean of apps’ items were 3.27 in Engagement, 3.96 in function, 3.30 in Aesthetics, 2.96 in Information and 2.73 in subjective quality items.

Conclusion: Few apps meet prespecified criteria for quality, content, and functionality for epilepsy self-management. Despite the rapid evolution of self-management apps, lack of validation studies is a significant concern that limits the clinical value of these apps. Moreover, having a guideline and benchmarking in the field of mobile application development, in epilepsy management, can help analyze the content of established applications.

1. Pandher PS, Bhullar KK (2016). Smartphone applications for seizure management. Health Informatics J, 22(2):209-20.
2. Escoffery C, McGee R, Bidwell J, et al (2018). A review of mobile apps for epi-lepsy self-management. Epilepsy Behav, 81:62-69.
3. Smith G, Modi AC, Johnson EK, et al (2018). Measurement in pediatric epilepsy self‐management: A critical review. Epilep-sia, 59(3):509-522.
4. Ridsdale L, Wojewodka G, Robinson EJ, et al (2018). The effectiveness of a group self‐management education course for adults with poorly controlled epilepsy, SMILE (UK): A randomized controlled trial. Epilepsia, 59(5):1048-1061.
5. Qudah B, Luetsch K (2019). The influence of mobile health applications on patient-healthcare provider relationships: a sys-tematic, narrative review. Patient Educ Couns, 102(6):1080-1089.
6. Sahu M, Grover A, Joshi A (2014). Role of mobile phone technology in health edu-cation in Asian and African countries: a systematic review. Int J Electron Healthc, 7(4):269-86.
7. Abbasgholizadeh Rahimi S, Menear M, Ro-bitaille H, Légaré F (2017). Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions? Glob Health Action, 10(sup3):1332259.
8. Mortenson WB, Singh G, MacGillivray M, et al (2019). Development of a Self-Management App for People with Spinal Cord Injury. J Med Syst, 43(6):145.
9. Aliasgharpour M, Nayeri ND, Yadegary MA, Haghani H (2013). Effects of an ed-ucational program on self-management in patients with epilepsy. Seizure, 22(1):48-52.
10. Shegog R, Begley CE (2017). Clinic-based mobile health decision support to en-hance adult epilepsy self-management: an intervention mapping approach. Front Public Health, 5:256.
11. Shan R, Sarkar S, Martin SS (2019). Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia, 62(6):877-887.
12. Domnich A, Arata L, Amicizia D, et al (2016). Development and validation of the Italian version of the Mobile Applica-tion Rating Scale and its generalisability to apps targeting primary prevention. BMC Med Inform Decis Mak, 16:83.
13. Stoyanov SR, Hides L, Kavanagh DJ, et al (2015). Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth, 3(1):e27.
14. Choi YK, Demiris G, Lin S-Y, et al (2018). Smartphone applications to support sleep self-management: review and evaluation. J Clin Sleep Med, 14(10):1783-1790.
15. McKay FH, Cheng C, Wright A, et al (2018). Evaluating mobile phone applications for health behaviour change: a systematic re-view. J Telemed Telecare, 24(1):22-30.
16. Chavez S, Fedele D, Guo Y, et al (2017). Mobile apps for the management of dia-betes. Diabetes Care, 40(10):e145-e146.
17. Brown HM, Bucher T, Collins CE, Rollo ME (2019). A review of pregnancy iPh-one apps assessing their quality, inclusion of behaviour change techniques, and nu-trition information. Matern Child Nutr, 15(3):e12768.
18. Bardus M, van Beurden SB, Smith JR, Abraham C (2016). A review and content analysis of engagement, functionality, aes-thetics, information quality, and change techniques in the most popular commer-cial apps for weight management. Int J Behav Nutr Phys Act, 13:35.
19. Salazar A, de Sola H, Failde I, Moral-Munoz JA (2018). Measuring the Quality of Mo-bile Apps for the Management of Pain: Systematic Search and Evaluation Using the Mobile App Rating Scale. JMIR Mhealth Uhealth, 6(10): e10718.
20. Ernst LdL, Harden CL, Pennell PB, et al (2016). Medication adherence in women with epilepsy who are planning pregnan-cy. Epilepsia, 57(12):2039-2044.
21. Casassa C, Levit ER, Goldenholz DM (2018). Opinion and Special Articles: Self-management in epilepsy: Web-based sei-zure tracking applications. Neurology, 91(21):e2027-e2030.
22. Fisher RS, Blum DE, DiVentura B, et al (2012). Seizure diaries for clinical research and practice: limitations and future pro-spects. Epilepsy Behav, 24(3):304-10.
23. DiIorio C, Bamps Y, Walker ER, Escoffery C (2011). Results of a research study evaluating WebEase, an online epilepsy self-management program. Epilepsy Behav, 22(3):469-74.
24. Escoffery C, Bamps Y, LaFrance Jr WC, et al (2015). Development of the adult epi-lepsy self-management measurement in-strument (AESMMI). Epilepsy Behav, 50:172-83.
25. Talwar D, Yeh Y-L, Chen W-J, Chen L-S (2019). Characteristics and quality of ge-netics and genomics mobile apps: a sys-tematic review. European Journal of Human Genetics, 833–840.
26. Marzuki NA, Husain W, Shahiri AM (2016). MyEpiPal: Mobile Application for Man-aging, Monitoring and Predicting Epilep-sy Patient. I International Conference on Ad-vances in Information and Communication Tech-nology, 383-392.
27. Fleur A Le Marne, Sharlene Butler, Erin Beavis, et al (2018). EpApp: Develop-ment and evaluation of a smartphone/tablet app for adolescents with epilepsy. J Clin Neurosci. 50:214-220.
IssueVol 50 No 3 (2021) QRcode
SectionReview Article(s)
Mobile application M-health Epilepsy Seizure Evaluation Mobile application rating scale

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How to Cite
MOHAMMADZADEH N, KHENARINEZHAD S, GHAZANFARISAVADKOOHI E, SAFARI MS, PAHLEVANYNEJAD S. Evaluation of M-Health Applications Use in Epilepsy: A Systematic Review. Iran J Public Health. 2021;50(3):459-469.