# Mobile Applications for Epilepsy: Where Are We? Where Should We Go? A Systematic Review
### Seizure Diary and Self-Report  
The concept of seizure diary consists of keeping track of seizures on a daily basis. Self-report indicates that this tracking is performed by the patient. Initially, self-report was performed through paper-based seizure diaries, first evolving to web-pages [8], whereas nowadays, we have several electronic solutions available at hand for self-report.  
The act of self-report was firstly presented by [PERSON] in 1977 [9], through the psychological theory of self-efficacy, which stated that active self-management could positively contribute to chronic disease control. In the 1990s, upon the success of self-management towards other chronic diseases (such as diabetes), [PERSON] and colleagues [10] proposed that the self-management of epilepsy could enhance seizure control and improve well-being. This was proven by [PERSON] and coworkers, through a randomised controlled trial in 2015 [11].  
Besides the benefit of self-efficacy, if the self-report is associated to the patient-doctor communication, it provides valuable information to health professionals, allowing them to better understand treatment adherence and seizure improvement over time. Moreover, clinical trials of anti-seizure medication (ASM), performed by pharmaceutical companies, also use self-reporting in their studies, which emphasises the importance of accurate seizure tracking.  
[PERSON] and colleagues [12] interviewed more than 100 participants of ASM clinical trials and discussed the issue of under-report: over 40% of noticed seizures were not reported. Regarding annotation tools, it was mentioned a prevalence of 73.4% regarding paper-based seizure diaries, when compared to electronic versions, due to ease of use. However, paper diaries were usually filled later on, thereby increasing forgetfulness and memory-associated errors. This study highlighted the role of electronic diaries (e-diaries) in reducing under-report, through the use of daily reminders. However, to accomplish better self-report, this study also recognised the major role of low-complex solutions, emphasizing the need for simple and fast user interaction with e-diaries.  
The widespread use of technology in our daily life has brought new possibilities to epilepsy. Recently, [PERSON] et al. [13] published the results of using an e-diary in a randomised, controlled clinical trial, achieving an e-compliance of 83.6%. Through using daily diary reminders, 90% of seizure events were reported within 1 day after their occurrence. This e-diary was provided to patients in a handheld device. Some patients still relied occasionally on paper backup diary entries, with the following reasons stated: lacking availability of the e-diary; forgetting entry into the e-diary; or losing it.  
Due to the increasing pervasiveness of smartphones, mobile apps are mostly available in a near range, and easy to access on a daily basis, whenever necessary. Following this line of thought, seizure self-report through a mobile app combines the advantages of e-diaries, with being always at hand. Besides seizure reporting, a mobile app could also provide additional features, such as adverting for medicine intake, doctor appointments and keeping track of relevant occurrences. The management of available content should be carefully thought to maintain adherence, by juggling simplicity with engagement.