AUTHOR=Georgas Konstantinos , Bromis Konstantinos , Vagenas Theodoros P. , Giannakopoulou Olympia , Vasileiou Nikolaos , Kouris Ioannis , Haritou Maria , Matsopoulos George K. TITLE=eHealth literacy assessment as a promoter of user adherence in using digital health systems and services. A case study for balance physiotherapy in the TeleRehaB DSS project JOURNAL=Frontiers in Digital Health VOLUME=Volume 7 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1535582 DOI=10.3389/fdgth.2025.1535582 ISSN=2673-253X ABSTRACT=Improving patient adherence and compliance with digital health interventions requires the creation of eHealth literacy resources. This study examines the creation and application of a novel eHealth literacy tool for home-based balance physiotherapy as part of the TeleRehaB DSS project. This tool evaluates patients’ digital literacy, in particular their ability to use the Internet of Things (IoT), Augmented Reality (AR) and smart device technologies. The tool addresses the challenge of low treatment adherence by utilizing models to monitor compliance in real time and adjust treatment recommendations accordingly. The TeleRehaB DSS integrates this literacy tool to maximize resource allocation and improve patient engagement. Testing and validation has shown the system’s ability to improve therapeutic outcomes and increase patient involvement. This strategy not only addresses the real-world difficulties of implementing digital health systems, but also advances the growing body of knowledge on improving treatment adherence through customized digital literacy assessments. When developing effective health technologies, the capabilities of users must be taken into account, especially for older people or those with limited digital literacy, as this study highlights.