Systematic review of Saudi neurologists' telehealth intentions and attitudes reveals regional and institutional adoption gaps.

Telehealth has increasingly been integrated into neurological practice worldwide, particularly following the COVID-19 pandemic. Despite national efforts to expand telehealth services in Saudi Arabia, evidence on neurologists’ telehealth use, attitudes, and intentions to adopt telehealth in routine practice remains limited. A national cross-sectional survey was conducted among neurologists practicing in Saudi Arabia to assess attitudes and intentions toward telehealth use. Participants were recruited via snowball sampling to complete a structured, self-administered questionnaire. The required sample size was calculated for a finite population and estimated at 281; a total of 300 neurologists were recruited to account for non-responses. Survey validity was established through expert content review and face validity testing, while reliability was confirmed using Cronbach’s alpha (0.73) and test–retest correlation (r = 0.82). Descriptive statistics summarized responses, and inferential analyses—including chi-square tests, Mann–Whitney U tests, and multivariate logistic regression, were performed to identify factors associated with intention to use telehealth, with p  Overall, 78.7% (n = 236) intended to use telehealth. Intention was significantly higher among neurologists working in the Central region (39.8% vs. 20.3%, p = 0.017), governmental institutions (89.8% vs. 73.4%, p = 0.001), and tertiary care centers (51.3% vs. 32.8%, p = 0.030), and among consultants compared with specialists (36.0% vs. 21.9%, p = 0.006). Confidence in telehealth was higher for follow-up care than for new patients (82.7% vs. 24.0%, p  Most surveyed neurologists reported a high intention to use telehealth. Confidence in telehealth was higher for follow-up care than for new-patient consultations. Overall attitudes toward telehealth were moderately positive and were significantly associated with the intention to use the service. Familiarity with telehealth, positive attitudes toward follow-up care, and institutional provision of audio services were identified as significant independent factors associated with telehealth adoption. These findings underscore the importance of individual and organizational factors in shaping neurologists’ willingness to adopt telehealth, suggesting that targeted strategies to enhance adoption should focus on increasing familiarity, promoting positive attitudes, and ensuring institutional support.