Societal Acceptability of People with Epilepsy: A Mixed-Methods Systematic Review with Targeted Meta-Analyses

This mixed-methods review examined how societal acceptability of people with epilepsy is conceptualised, measured, and shaped across contexts. Reported sources included MEDLINE, PubMed, EBSCOhost, CINAHL, Europe PMC, Web of Science, and Google Scholar. Empirical reports published during 2016–2026 were appraised using the Mixed Methods Appraisal Tool 2018. Quantitative narrative and thematic findings were integrated, with post hoc random-effects meta-analyses of comparable willingness outcomes. The synthesis included 248 reports; 31 contributed to the targeted quantitative dataset. Public/community-favourable responses were estimated at 37.0% for marriage (95% CI, 26.3–49.1), 63.5% for workplace contact (37.5–83.5), and 66.2% for child contact (56.1–75.0). Educator estimates were 35.9% for marriage (28.7–43.7) and 75.1% for child contact (60.1–85.8). Heterogeneity was substantial (I2 = 72.7–99.5%), with wide prediction intervals. Integrated findings highlighted relationship-specific acceptance, institutional decisions, disclosure, and support that could enable participation or constrain autonomy. Intervention findings were mixed, with uncertain sustained behavioural benefits. Search provenance, sampling and measurement limitations, possible cohort overlap, and undocumented independent verification procedures constrained interpretation. Societal acceptability is multidimensional and context-dependent; no overall acceptance estimate or worldwide prevalence can be inferred. Inclusion initiatives require stakeholder involvement, culturally appropriate measurement, and evaluation of participation, autonomy, and treatment by others.