Accessibility barriers in mobile medical applications for users with cognitive impairments: analysis, impact assessment, and design recommendations

Анотація

Relevance. The rapid digitalization of healthcare has led to the widespread adoption of mobile medical applications for health monitoring, medication management, telemedicine services, and continuous patient–provider communication. At the same time, a significant proportion of users of these applications are individuals with cognitive impairments, including age-related cognitive decline, ADHD, post-stroke deficits, dementia, and other neurocognitive conditions. Insufficient adaptation of mobile healthcare applications to the cognitive needs of these users creates substantial barriers to effective interaction, increasing the risk of errors and negatively affecting treatment adherence, patient safety, and healthcare outcomes. Purpose. The study aims to identify the primary cognitive accessibility barriers present in mobile medical applications, assess their impact on the safety and effectiveness of digital healthcare services, and develop practical recommendations for improving interface design for users with cognitive impairments. Methods. The research is based on a review of peer-reviewed scientific publications published between 2020 and 2025, combined with a heuristic evaluation of three widely used healthcare applications – MyChart, Medisafe, and Ada – against the cognitive accessibility criteria of WCAG 2.1. The study employs methods of literature synthesis, comparative analysis, and expert assessment of interface design solutions. Results. Six major categories of cognitive accessibility barriers were identified: excessive navigation depth, information overload, unpredictable interface behavior, inadequate error prevention and recovery mechanisms, absence of multimodal communication, and insufficient personalization. The findings demonstrate that these barriers directly affect users’ decision-making processes, complicate the completion of critical healthcare tasks, reduce treatment adherence, and may lead to clinically significant consequences. The findings further indicate that simplified navigation paths, stable interaction patterns, user-friendly error recovery mechanisms, multimodal information presentation, and adaptive interface solutions may significantly improve accessibility and usability for users with cognitive impairments. Conclusions. Cognitive accessibility is a fundamental prerequisite for ensuring equitable access to digital healthcare services and enhancing patient safety. Addressing the identified barriers requires the systematic integration of cognitive accessibility principles throughout the design and development process, the adoption of inclusive design practices, and the active involvement of individuals with cognitive impairments in usability testing and interface evaluation. Such measures can improve treatment adherence, reduce interaction-related errors, and support safer engagement with digital healthcare services.