Impact of LLM-supported patient education on patient perspectives and patient-reported outcomes: a mixed-methods systematic review

Large language models (LLMs) are increasingly being explored for patient education, but evidence from patient-facing clinical studies involving real patients remains limited. We conducted a mixed-methods systematic review of LLM-supported patient education in clinical settings, focusing on patterns of use, patient perspectives, and patient-reported outcomes. Searches of PubMed, Embase, Scopus, Web of Science, and CINAHL identified 48 eligible studies from 17 countries.

LLMs were mainly used to answer patient questions, generate educational materials, and simplify medical information. Patients generally valued LLM-supported education for clarity, accessibility, and usefulness, but raised concerns about accuracy, privacy, personalization, trust, and emotional support. Quantitative findings were most consistent for cognitive and information-related outcomes, whereas evidence for satisfaction, trust, empathy, preference, behavioral outcomes, and longer-term effects was mixed or limited.

Current evidence supports the use of LLMs as adjuncts to patient education, particularly for improving access to and understanding of medical information, while clinician–patient communication remains essential for personalized explanation, trust building, and shared decision-making. This study was jointly supported by the Fundamental Research Funds for the Central Universities (No. lzujbky-2024-oy11), National Science and Technology Major Project for the Prevention and Treatment of Cancer, Cardiovascular and Cerebrovascular, Respiratory and Metabolic Diseases (2024ZD0524100, 2024ZD0524103), and Traditional Chinese Medicine Innovation Team and Talent Support Program - National Traditional Chinese Medicine Multidisciplinary Cross-Innovation Team Project (ZYYCXTD-D-202401). Department of Health Policy and Health Management, School of Public Health, Lanzhou University, Lanzhou, China Jiayi Liu, Yanan Zhang, Honghao Lai, Min Han, Ning Ma, Weilong Zhao, Danni Xia, Bo Tong, Yanru Liu, Yimeng Li & Long Ge Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China Sibo Du, Bei Pan, Xiaoman Wang, Bingyi Wang & Janne Estill Vincent V.C.

Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China Chinese EQUATOR Centre, Hong Kong SAR, China Institute of Global Health, University of Geneva, Geneva, Switzerland The Second People’s Hospital of Lanzhou, Lanzhou, China Publicity Division, Chinese Center for Health Education, Beijing, China WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China The authors declare no competing interests. Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Liu, J., Zhang, Y., Lai, H. et al. Impact of LLM-supported patient education on patient perspectives and patient-reported outcomes: a mixed-methods systematic review. npj Digit.