MOBILE SYSTEMS Utility of a mHealth App for Self-Management and Education of Cardiac Diseases in Spanish Urban and Rural Areas Valentín González de Garibay 1 & Miguel A. Fernández 1 & Isabel de la Torre-Díez 2 & Miguel López-Coronado 2 Received: 18 January 2016 /Accepted: 26 May 2016 # Springer Science+Business Media New York 2016 Abstract Analyze the utility of a mobile health app named HeartKeeper in several groups of population and obtain con- clusions to be applied to other similar apps. A questionnaire has been designed to evaluate the usage and utility of the HeartKeeper app. The questionnaire information was col- lected by collaborating cardiologists from 32 patients before and after they used the app. Patients were randomly selected with established quotas within interest groups, so that men and women, patients older or younger than 60 years old and patients living in urban or rural areas were equally repre- sented. Using the appropriate statistical techniques we see that the HeartKeeper app was useful for patients as they qualify with 70 points (out of 100) the overall opinion of the app, it helps them remember more easily taking their pills with a mean improvement of 20.94 points (p < 0.001) and they perceive a global improvement of their health (8.28 points, p < 0.001). We also observe that these improvements do not depend, in general, on the area (urban or rural) where the patient comes from or on their sex. Although older patients needed more help to use the app and used it slightly less frequently, the improvements on several measures considered, such as remembering taking pills, breathing problems or trou- ble developing activities, depend significantly (p < 0.05) on age with older patients reporting higher improvements than younger ones. The results obtained with the sample of patients considered in this research prove the utility of the HeartKeeper app. This utility is similar in urban and rural areas and for patients of both sexes and, to some extent, depends on the age of the patient with older patients reporting slightly lower frequency of use but higher health improvements than younger ones. Keywords Cardiac diseases . m-Health . Rural . Urban . Utility Introduction Nowadays there are almost 100,000 mHealth apps in several catalogs such as Google Play by Android, iTunes App Store by Apple, etc. Most of these apps are treated support tools that facilitate individual members follow certain health parame- ters, besides providing varied health information [1–3]. Moreover, this number of apps is increasing day by day. The rapid growth in mHealth apps has outpaced the science needed to validate the utility of health-related applications [4–6]. Cardiovascular diseases are the deadliest diseases world- wide. The heart-related deaths are of the utmost relevance; a fact easily proven by the 7.25 million deaths caused by ische- mic heart disease alone in 2008 [7–9]. The latest advances in smartphones and mHealth have been used in the creation of health apps related to cardiology. These apps can help to reduce the mortality rates. The authors of this research have created a mobile health app for managing patients with cardiac diseases such as cardiopathies amongst others, and educating about heart problems for any user. This app is named HeartKeeper [10, 11]. It is available on Google Play. HeartKeeper has been developed to improve This article is part of the Topical Collection on Mobile Systems * Isabel de la Torre-Díez isator@tel.uva.es 1 Department of Statistics and Operations Research, University of Valladolid, Paseo de Belén, 7, 47011 Valladolid, Spain 2 Department of Signal Theory and Communications, and Telematics Engineering, University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain J Med Syst (2016) 40:186 DOI 10.1007/s10916-016-0531-4