JMIR Publications

ABSTRACT

Background:

Medication adherence in cancer patients is reported to be below 50%, remaining at a generally low level. Poor medication adherence significantly compromises treatment outcomes for cancer patients, increasing the risk of tumor recurrence, worsening symptom burden, and even death, while reducing patients' quality of life and survival rates. In recent years, mobile health technologies have been recommended to improve medication adherence in cancer patients.

Objective:

To evaluate the effect of mobile health on improving medication adherence in cancer patients.

Methods:

A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A systematic search was conducted across five English-language databases (PubMed, Web of Science, CINAHL, Cochrane Library, Embase), three Chinese-language databases (Sinomed, China National Knowledge Infrastructure, Cqvip), and two clinical trial registries (CHICTR, Clinicaltrials.gov) for randomized controlled trials (RCTs) from the inception of each database up to June 28, 2025.

Results:

This review included 15 randomized controlled trials (RCTs) involving 1,246 participants. Mobile health interventions comprised mobile applications, websites, and text message services. Results indicate that compared to the control group, mobile health not only improved the rate of medication adherence OR 2.56 (95% CI 1.31 to 4.99) (P = .006), mean medication adherence Score SMD 1.06 (95% CI 0.67 to 1.46) (P < .001), quality of life SMD 1.36 (95% CI 0.49 to 2.23) (P = .002), health literacy SMD 0.51 (95% CI 0.20 to 0.82) (P = .001), and service satisfaction, but also reduced symptom burden SMD -0.72 (95% CI -1.17 to -0.26) (P = .002). Subgroup analysis indicates that compared to mobile health interventions lasting < 3 months, those lasting ≥3 months significantly improved the rate of medication adherence in cancer patients OR 5.76 (95% CI 2.88 to 11.54). Compared to mobile applications and websites, text message services are more effective in improving the mean medication adherence scores of patients with cancer SMD 1.53 (95% CI 0.45 to 2.61).

Conclusions:

Mobile health not only improves medication adherence, quality of life, health literacy, and service satisfaction among cancer patients but also reduces their symptom burden. Mobile health interventions lasting at least 3 months yield better outcomes, and text message services are more effective forms of mobile health. Given the limited number of studies included in this systematic review, healthcare professionals should conduct more high-quality research to further validate the effectiveness of mobile health interventions in improving medication adherence among cancer patients. Clinical Trial: PROSPERO CRD420251162181; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251162181