Patient engagement and performance expectancy towards epilepsy digital health interventions: systematic literature review and meta-analysis.

Abstract

Digital Health is currently showing promising results in reducing patient and caregiver suffering that arise from misconceptions. To synthesize existing evidence on Perceived Usefulness, interest in use and willingness to use towards Epilepsy Digital Health Interventions. Databases were searched for studies reporting on the outcomes of interest by using a comprehensive search strategy. Studies published in English from January 2015 to September 2025 were included. The Newcastle-Ottawa Quality Assessment Scale was employed to evaluate the quality of included studies. Stata version 19 was used to compute a pooled proportion using a random-effects model. Heterogeneity was assessed using the Cochrane chi-square and the index of heterogeneity test. Sensitivity tests and subgroup analyses were performed. Publication bias was examined by funnel plots and Egger's test. Overall, 6041 studies were found from databases. After a step-by-step screening, 23 studies were included in this review. The total number of participants was 6703 with a sample size ranges from 12 to 1168. The pooled proportions of Perceived Usefulness, interest to use, and willingness to use Digital Health were 0.66 (0.58, 0.75), 0.69 (0.50, 0.88), and 0.75 (0.66, 0.83), respectively. In this review, Sensitivity tests indicated that none of the included studies exerted extreme influence on the pooled prevalence; and Funnel plots and Egger's test (p ≤ 0.772) showed no evidence of publication bias. In this review, 66% of respondents perceive Digital Health as useful; 69% were interested in using Digital Health, and 75% were willing to engage with Digital Health. Most of the studies were from high-income countries, with no studies found from developing countries. This review emphasizes the importance of focusing on the user's perceptions, their interest and willingness to use Digital Health Interventions. It also stresses the need for further studies in low-income countries.