Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 16, 2025
Date Accepted: Apr 13, 2026
Effect of Digital Health Interventions on the Nutritional Status and Quality of life of Colorectal Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
ABSTRACT
Background:
Colorectal cancer (CRC) often induces gastrointestinal dysfunction, anorexia, and psychological distress such as anxiety and depression, all of which negatively affect patients’ nutritional status and quality of life (QoL). Digital health interventions, including mobile applications for nutritional monitoring, web-based platforms for remote guidance, and short message services that facilitate clinician-patient communication, have emerged as a promising tool to complement conventional in-hospital care. By improving treatment adherence, patient engagement, and self-management competencies, these interventions may lead to better rehabilitation outcomes among CRC patients.
Objective:
This study systematically evaluated the impact of digital health interventions on the nutritional status and QoL of patients with colorectal cancer. Subgroup analyses were conducted to compare the effects of intervention duration on QoL outcomes.
Methods:
A comprehensive search was carried out in PubMed, Embase, Cochrane, and Web of Science databases up to August 26, 2025, using pre-defined search terms. Randomized controlled trials (RCTs) assessing digital health interventions for colorectal cancer patients were included. Two reviewers independently screened and extracted the data. Primary outcomes were nutritional status and QoL. Meta-analyses were performed using mean difference (MD) and standardized mean difference (SMD) with 95% confidence intervals (CIs).
Results:
Eleven RCTs from seven countries, involving 1,210 participants aged 40-69 years, met the inclusion criteria. Nine trials involved healthcare professionals delivering interventions through digital platforms, and eight incorporated adherence support strategies. Meta-analysis revealed that digital health interventions significantly improved nutritional status, as reflected by serum albumin levels (MD = 2.23, 95% CI 0.27 to 4.20; P = .03); A significant improvement in overall QoL was also observed (SMD = 0.67, 95% CI 0.21 to 1.14; P = .004). Subgroup analyses indicated that interventions lasting more than three months showed a trend towards greater QoL improvement (SMD 0.78, 95% CI -0.04 to 1.61; P = .06) (SMD 0.73, 95% CI -0.15 to 1.62; P = .10), compared with shorter interventions (<3 months), which showed no significant effects.
Conclusions:
Our findings suggest that digital health interventions appear to enhance nutritional status and QoL in CRC patients. However, due to limited sample sizes and heterogeneity across studies, their clinical significance remains inconclusive. Larger, well-designed RCTs with standardized outcome measures are warranted to confirm the long-term benefits of digital health-assisted nutritional management in CRC care. Clinical Trial: PROSPERO CRD420251125990; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251125990
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