Evaluation of free mobile health applications for pelvic organ prolapse and urinary incontinence

Background: Technology is becoming increasingly integrated into healthcare, including the rapid development of mobile health (mHealth) applications (apps) for various medical conditions such as urinary incontinence and pelvic organ prolapse (POP). As patients turn to these sources more frequently, closer evaluation of the apps becomes more important.

Objectives: To (1) evaluate free applications designed for POP and urinary incontinence using the Xcertia guidelines for medical app quality, (2) analyze user sentiment of the apps, and (3) evaluate app information for quality, understandability, and actionability with the DISCERN and the Patient Education Materials Assessment Tool (PEMAT) tools.

Methods: Mobile medical apps were identified on the Apple App Store or Google Play Store with keywords "pelvic organ prolapse," "incontinence," or "bladder." Exclusion criteria included 1) not free, 2) not updated in past year, 3) required a product for use, 4) not in English. Apps were evaluated using the Xcertia Guidelines. Categories included Operability, Privacy, Security, Content, and Usability. Ratings and sentiment of reviews were assessed, and associations analyzed with one-sided Fisher's exact test. Apps with an informational component were evaluated for quality, usability and actionability using DISCERN and PEMAT criteria.

Results: Overall, a total of 73 apps were found and 28 were included. There was an average number of ratings of 2341 and an average score of 3.39 for all the apps included. The average number of reviews was 216.2, with the majority of reviews having positive sentiment. A high number of ratings was associated with a high rating score (p < 0.05) and a high number of reviews was associated with a high percentage of positive reviews (p < 0.05). Based on Xcertia Guidelines, all apps met the guidelines for privacy, security, and usability. Regarding content, 67.9 % of apps incorporated an informational component, but only 17.9 % delineated sources. The average DISCERN score for information quality indicated good quality information (>3). The average PEMAT scores for Understandability and Actionability were 90.6 % and 86.6 %, respectively, which are good scores (≥75 %).

Conclusions: Most free apps were functional and well received by users, however quality of app content varied. Only some apps had an informational component, and even fewer had sources listed. Providers recommending health apps should consider those that meet Xcertia guidelines, have reliable information, and have good understandability and actionability.