A review of more than 200 neurology-focused apps found opportunities to improve language offerings and hybrid use with clinicians.
The study found opportunities for content improvement among apps for headache, sleep, and pain, including improvements in app structure and delivery of features.
The study, which is believed to be the largest review of publicly available neurology-focused app offerings to date, reviewed more than 200 apps for headache, pain, and insomnia across 105 dimensions.
These dimensions were based on criteria from the Mobile Health Index and Navigation Database (MIND), including diversity, equity, and inclusion criteria related to accessibility features and language options.
The characteristics of the top neurological apps discoverable on iOS and Android devices were evaluated and compared with those of a control group.
Pain and headache apps were found to share many common features. Symptom tracking was the most common feature in headache-related (32/48; 67%) and pain-related (21/47; 45%) apps, whereas mindfulness was the most common feature in sleep-related apps (73/106; 69%).
Although the most commonly offered features were tracking and mindfulness-related features, individual apps offered varied amounts or types of these features.
The investigators also noted that although 90% of apps were free to download, less than 50% of apps were truly free of cost.
Among all apps, privacy, accessibility, and crisis management resources were limited, highlighting concerns about app structure.
However, the authors note that, as of September 2021, the Federal Trade Commission expects wellness apps not covered by the Health Insurance Portability and Accountability Act (HIPAA) to follow HIPAA-related rules around breaches, suggesting that apps will need to change the required security process.
Only 8% of sleep-related apps, 2% of pain-related apps, and 0% of headache-related apps offer crisis resources that link a user to a hotline or put them in contact with a medical professional, showing a significant lack of crisis management features across all categories.
The authors also highlighted an opportunity for increased efforts around diversity and inclusion, as only 17% of the neurology-focused apps supported Spanish-language use.
Additionally, the majority of apps were self-help focused, with few being designed for use in partnership with a peer or clinicians.
“Across the broader digital health field, there is growing evidence that apps used in partnership with others may be more engaging and effective than the self-help ones,” wrote the authors. “Lessons already learned about low engagement with mental health apps may help these neurology-related apps develop as more engaging relationship-based tools that could offer more support for hybrid use.”
The authors also suggested that common features between neurology apps and mental health apps, including behavioral-based treatments and remote capture of symptoms, indicate a potential synergy between the fields.
“Patient care may be improved with the incorporation of a transdiagnostic approach to health-based smartphone app,” the authors concluded.
Limitations of the study included false advertising from several apps, the potential for inaccurately coded information, and paywalls limiting assessment of all features.
The authors noted that evaluating the effectiveness of smartphone apps is difficult; although these findings indicate what apps claim to offer, personal use is necessary to determine what apps meet the needs of each clinical use case.
Minen MT, George A, Camacho E, et al. Assessment of smartphone apps for common neurologic conditions (headache, insomnia, and pain): cross-sectional study. JMIR Mhealth Uhealth. 2022;10(6):e36761. doi:10.2196/36761