Intention to use smartphone medical applications among patients with chronic disease in southwest Ethiopia: an extended UTAUT2 model approach

Chronic diseases are a major global health burden, particularly in low and middle-income countries like Ethiopia, where they significantly contribute to mortality. This underscores a critical need for effective prevention strategies. Smartphone medical applications (apps) present a promising tool for lifestyle management, promoting healthy behaviors and empowering patients. However, although numerous international studies have examined the intention to use mobile health (mHealth) applications, evidence from resource-limited settings such as Ethiopia remains scarce, particularly among patients with multiple chronic diseases. Thus, this study aimed to identify predictors of patients with chronic disease’ intention to use medical apps for lifestyle management in Ethiopia by applying an adapted Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. An institutional-based cross-sectional study was conducted among patients with chronic disease attending public hospitals in southwest Ethiopia. Participants were selected via systematic random sampling. Data was collected using a structured, pretested questionnaire based on the UTAUT2 model. IBM SPSS was used for data coding and cleaning. Structural Equation Modelling (SEM), including Confirmatory Factor Analysis, was performed in AMOS version 23 to identify predictors, with statistical significance set at p < 0.05. Among 1,210 participants (94.0% response rate), 48.5% (95% CI: 46.7–52.4) expressed an intention to use medical apps. Performance expectancy (β = 0.60, p < 0.001) and facilitating conditions (β = 0.56, p < 0.001) were the strongest positive predictors of intention. Effort expectancy (β = 0.43), hedonic motivation (β = 0.39), and trust (β = 0.43) were also significantly and positively associated with intention. In contrast, greater privacy concerns were associated with lower intention (β = -0.34). The intention to use medical apps among Ethiopian patients with chronic disease is strongly influenced by performance expectancy and the availability of supportive infrastructure, while privacy concerns are a significant barrier. To enhance adoption, policymakers should strengthen digital health infrastructure and enact robust privacy protections. Clinicians should promote app utility by demonstrating clinical benefits, and developers must prioritize user-friendly design and stringent data security. These combined efforts can improve lifestyle management and reduce chronic disease complications.