{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:12:53Z","timestamp":1787166773671,"version":"build-2736575974"},"reference-count":55,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Medication adherence among patients with cancer is generally low. Mobile health (mHealth) has gradually been applied to improve this situation, but systematic evidence of its effectiveness remains lacking.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to evaluate the effect of mHealth on improving medication adherence among patients with cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This systematic review included randomized controlled trials (RCTs) evaluating the impact of mHealth on medication adherence among patients with cancer. Systematic searches were conducted in PubMed, Web of Science, CINAHL, Cochrane Library, Embase, Sinomed, CNKI, Cqvip, and ClinicalTrials.gov from inception to December 31, 2025. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. Effects were pooled using a random-effects model (Hartung-Knapp-Sidik-Jonkman), and standardized mean differences (SMDs) and odds ratios (ORs) with 95% CIs have been reported. Evidence quality was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 17 RCTs (1309 participants) from 8 countries published between 2016 and 2025 were included. mHealth interventions included mobile apps, websites, and text messaging services. The meta-analysis revealed that compared with controls, mHealth interventions significantly improved medication adherence rates (OR 3.47, 95% CI 1.92-6.26;\n P<\/jats:italic>\n =.002), medication adherence scores (SMD 1.01, 95% CI 0.51-1.52;\n P<\/jats:italic>\n =.001), self-efficacy (SMD 0.90, 95% CI 0.29-1.51;\n P<\/jats:italic>\n =.01), and service satisfaction while reducing symptom burden (SMD \u22120.38, 95% CI \u22120.61 to \u22120.14;\n P<\/jats:italic>\n =.008). However, mHealth had no significant effect on health literacy (SMD 0.51, 95% CI \u20131.50 to 2.52;\n P<\/jats:italic>\n =.29). Subgroup analysis revealed that interventions lasting <3 months outperformed those lasting \u22653 months in improving adherence scores (SMD 1.37, 95% CI 0.78-1.96 vs SMD 0.49, 95% CI \u22120.39 to 1.37;\n \u03c7<\/jats:italic>\n \u00b2\n 1<\/jats:sub>\n =5.98;\n P<\/jats:italic>\n =.01). Regarding intervention format, text messaging services demonstrated superior efficacy compared with mobile apps and websites (SMD 1.53, 95% CI \u22125.49 to 8.55 vs SMD 1.01, 95% CI 0.42-1.61 and SMD 0.11, 95% CI \u22120.34 to 0.56, respectively;\n \u03c7<\/jats:italic>\n \u00b2\n 2<\/jats:sub>\n =10.28;\n P<\/jats:italic>\n =.006). Across cancer types, mHealth most significantly improved adherence scores in patients with breast cancer (SMD 1.29, 95% CI \u22125.25 to 7.83), outperforming the findings in patients with leukemia and other cancer types (SMD 0.28, 95% CI \u22120.87 to 1.42 and SMD 1.09, 95% CI 0.10-2.08, respectively;\n \u03c7<\/jats:italic>\n \u00b2\n 2<\/jats:sub>\n =8.86;\n P<\/jats:italic>\n =.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our findings confirm that mHealth plays a positive role in improving medication adherence, enhancing patient self-efficacy, increasing patient satisfaction with services, and alleviating symptom burden. However, these findings should be interpreted with caution owing to substantial heterogeneity, a moderate risk of bias, and a low certainty of evidence. Future research should enhance methodological quality by conducting multicenter, large-sample, high-quality RCTs and should explore the long-term effects and cost-effectiveness of mHealth across diverse health care settings and patient populations to clarify its role and value within comprehensive cancer care management systems.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/85949","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T12:05:07Z","timestamp":1772539507000},"page":"e85949-e85949","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of Mobile Health for Improving Medication Adherence in Patients With Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6802-2740","authenticated-orcid":false,"given":"Wei Chao","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9329-1603","authenticated-orcid":false,"given":"Li Ping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0687-0427","authenticated-orcid":false,"given":"Qian Yu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3542-5347","authenticated-orcid":false,"given":"Jing Han","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"issue":"12","key":"R1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.100287","article-title":"Cost variation and affordability of oral targeted cancer therapy in India: comparison of branded and janaushadhi products","volume":"17","author":"Lohi","journal-title":"Cureus"},{"issue":"4","key":"R2","doi-asserted-by":"publisher","first-page":"92","DOI":"10.3870\/j.issn.1001-4152.2025.04.092","article-title":"Summary of best evidence for prevention and management of oral chemotherapy drugs exposure in cancer patients at home [Article in Chinese]","author":"Yan","journal-title":"Journal of Nursing Science"},{"issue":"14","key":"R3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.3870\/j.issn.1001-4152.2024.14.126","article-title":"Research progress on medication literacy of cancer patients receiving oral antineoplastic drugs [Article in Chinese]","volume":"39","author":"Yunyi","journal-title":"Journal of Nursing Science"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1111\/j.1524-4733.2007.00213.x","article-title":"Medication compliance and persistence: terminology and definitions","volume":"11","author":"Cramer","journal-title":"Value Health"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"306","DOI":"10.18553\/jmcp.2025.31.3.306","article-title":"The impact of patient characteristics and social drivers of health factors on oral oncolytic adherence","volume":"31","author":"Uyehara","journal-title":"J Manag Care Spec Pharm"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2196\/57199","article-title":"Impact of patient personality on adherence to oral anticancer medications: an opportunity?","volume":"10","author":"Jafari","journal-title":"JMIR Cancer"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1136\/ejhpharm-2024-004205","article-title":"Patient reported medication-related problems, adherence and waste of oral anticancer medication over time","volume":"32","author":"van den Bemt","journal-title":"Eur J Hosp Pharm"},{"issue":"12","key":"R8","doi-asserted-by":"publisher","first-page":"121","DOI":"10.20116\/j.issn2095-0616.2025.12.25","article-title":"Single-center evaluation of adherence to immunosuppressive drugs and assessment of influencing factors in 152 renal transplant recipients [Article in Chinese]","volume":"15","author":"Tongyu","journal-title":"China Medicine and Pharmacy"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1097\/01.mlr.0000114908.90348.f9","article-title":"Variations in patients\u2019 adherence to medical recommendations: a quantitative review of 50 years of research","volume":"42","author":"DiMatteo","journal-title":"Med Care"},{"issue":"2","key":"R10","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/HPC.0000000000000231","article-title":"Effect of medication adherence and early follow-up on unplanned readmission post-myocardial infarction: quality improvement in a safety net hospital","volume":"20","author":"Ashraf","journal-title":"Crit Pathw Cardiol"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25094844","article-title":"The impact of inadequate exposure to epidermal growth factor receptor-tyrosine kinase inhibitors on the development of resistance in non-small-cell lung cancer cells","volume":"25","author":"Frezzetti","journal-title":"Int J Mol Sci"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/76880","article-title":"The application of mobile health in self-management among patients undergoing dialysis: scoping review","volume":"28","author":"Xu","journal-title":"J Med Internet Res"},{"issue":"9","key":"R13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057868","article-title":"Patient-reported outcome measures to detect intentional, mixed, or unintentional non-adherence to medication: a systematic review","volume":"12","author":"Fahrni","journal-title":"BMJ Open"},{"issue":"11","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/39819","article-title":"Effectiveness of mobile medical apps in ensuring medication safety among patients with chronic diseases: systematic review and meta-analysis","volume":"10","author":"Zhou","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"R15","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1089\/jayao.2018.0072","article-title":"Oral medication adherence among adolescents and young adults with cancer before and following use of a smartphone-based medication reminder app","volume":"8","author":"Linder","journal-title":"J Adolesc Young Adult Oncol"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","journal-title":"BMJ"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","journal-title":"Syst Rev"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/80476","article-title":"Tele-cognitive behavioral therapy for the treatment of diabetes-related distress in idividuals with diabetes mellitus: systematic review and meta-analysis of randomized controlled trials","volume":"27","author":"Xu","journal-title":"J Med Internet Res"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"133","DOI":"10.6004\/jnccn.2019.7354","article-title":"Randomized trial of a smartphone mobile app to improve symptoms and adherence to oral therapy for cancer","volume":"18","author":"Greer","journal-title":"J Natl Compr Canc Netw"},{"issue":"24","key":"R20","doi-asserted-by":"publisher","first-page":"12","DOI":"10.19435\/j.1672-1721.2023.24.004","article-title":"Application of mobile health education in improving medication compliance of elderly patients with endocrine therapy for prostate cancer [Article in Chinese]","volume":"27","author":"He","journal-title":"The Medical Forum"},{"issue":"9","key":"R21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3969\/J.ISSN.1672-8270.2020.09.008","article-title":"The effects of application of hospital information platform of interactively medical treatment based on \u201cInternet +\u201d on medication compliance and quality of life during follow-up of patients with abdominal aortic aneurysm surgery [Article in Chinese]","volume":"17","author":"Wang","journal-title":"China Medical Equipment"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09153-9","article-title":"Effectiveness of digital care platform CMyLife for patients with chronic myeloid leukemia: results of a patient-preference trial","volume":"23","author":"Verweij","journal-title":"BMC Health Serv Res"},{"issue":"oct18 2","key":"R23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","journal-title":"BMJ"},{"key":"R24","unstructured":"Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party. Supporting document for the Joanna Briggs Institute levels of evidence and grades of recommendation. The Joanna Briggs Institute. 2014. URL: https:\/\/jbi.global\/sites\/default\/files\/2019-05\/JBI%20Levels%20of%20Evidence%20Supporting%20Documents-v2.pdf [Accessed 23-03-2026]"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25","article-title":"The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method","volume":"14","author":"IntHout","journal-title":"BMC Med Res Methodol"},{"issue":"4","key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.imr.2023.101014","article-title":"How to understand and report heterogeneity in a meta-analysis: the difference between I-squared and prediction intervals","volume":"12","author":"Borenstein","journal-title":"Integr Med Res"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1177\/0962280218773520","article-title":"Prediction intervals for random-effects meta-analysis: a confidence distribution approach","volume":"28","author":"Nagashima","journal-title":"Stat Methods Med Res"},{"key":"R28","doi-asserted-by":"crossref","unstructured":"Higgins JPT Thomas J Chandler J et al. Cochrane Handbook for Systematic Reviews of Interventions. 2nd ed. John Wiley & Sons; 2019. [doi: 10.1002\/9781119536604]","DOI":"10.1002\/9781119536604"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1177\/096228029300200202","article-title":"The statistical basis of meta-analysis","volume":"2","author":"Fleiss","journal-title":"Stat Methods Med Res"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","journal-title":"BMJ"},{"issue":"23","key":"R31","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015987","article-title":"The trim-and-fill method for publication bias: practical guidelines and recommendations based on a large database of meta-analyses","volume":"98","author":"Shi","journal-title":"Medicine (Abingdon)"},{"issue":"6","key":"R32","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1089\/tmj.2015.0126","article-title":"Proof of concept of a mobile health short message service text message intervention that promotes adherence to oral anticancer agent medications: a randomized controlled trial","volume":"22","author":"Spoelstra","journal-title":"Telemed J E Health"},{"issue":"10","key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9559","article-title":"A mobile game for patients with breast cancer for chemotherapy self-management and quality-of-life improvement: randomized controlled trial","volume":"20","author":"Kim","journal-title":"J Med Internet Res"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2021.101969","article-title":"The effect of a mobile application on treatment adherence and symptom management in patients using oral anticancer agents: a randomized controlled trial","volume":"52","author":"Karaaslan-E\u015fer","journal-title":"Eur J Oncol Nurs"},{"issue":"9","key":"R35","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1111\/jan.12978","article-title":"Impact of tailored patient education on adherence of patients with chronic myeloid leukaemia to tyrosine kinase inhibitors: a randomized multicentre intervention study","volume":"72","author":"Kek\u00e4le","journal-title":"J Adv Nurs"},{"issue":"9","key":"R36","doi-asserted-by":"publisher","first-page":"927","DOI":"10.11877\/j.issn.1672-1535.2022.20.09.15","article-title":"Effects of mobile health intervention on endocrine therapy compliance andthyroid stimulating hormone compliance rate in postoperative patients withthyroid stimulating hormone compliance rate in postoperative patients withthyroid cancerthyroid cancer [Article in Chinese]","volume":"20","author":"Wang","journal-title":"Oncology Progress"},{"issue":"8","key":"R37","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.12104\/j.issn.1674-4748.2022.08.030","article-title":"The effect of a mobile health-based chronic disease management system on medication adherence, negative emotions, and blood pressure improvement in pheochromocytoma patients [Article in Chinese]","volume":"20","author":"Che","journal-title":"Chinese General Practice Nursing"},{"issue":"5","key":"R38","doi-asserted-by":"publisher","first-page":"151692","DOI":"10.1016\/j.soncn.2024.151692","article-title":"The effect of education and monitoring via tele-nursing to elderly cancer patients using oral anticancer agents on self-efficacy and medication adherence: a randomized controlled trial","volume":"40","author":"Ba\u015fo\u011flu","journal-title":"Semin Oncol Nurs"},{"issue":"10","key":"R39","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1200\/OP.24.00031","article-title":"Leveraging mobile health to improve capecitabine adherence among women with breast cancer: a pilot randomized controlled trial","volume":"20","author":"Graetz","journal-title":"JCO Oncol Pract"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.2196\/65302","article-title":"Digital solution to support medication adherence and self-management in patients with cancer (SAMSON): pilot randomized controlled trial","volume":"9","author":"Dang","journal-title":"JMIR Form Res"},{"issue":"3","key":"R41","doi-asserted-by":"publisher","first-page":"751","DOI":"10.31557\/APJCP.2025.26.3.751","article-title":"Check the impact of mobile health on medication adherence in adolescents with leukemia","volume":"26","author":"Hosseinpour","journal-title":"Asian Pac J Cancer Prev"},{"issue":"6","key":"R42","doi-asserted-by":"publisher","first-page":"771","DOI":"10.3969\/j.issn.1005-5916.2018.06.024","article-title":"Practical experience in implementing health education for cancer pain patients using the \u201c317 Care\u201d app in the context of \u201cInternet Plus\u201d [Article in Chinese]","volume":"38","author":"Lin","journal-title":"Chinese Rural Health Service Administration"},{"issue":"6","key":"R43","doi-asserted-by":"publisher","first-page":"E874","DOI":"10.1097\/NCC.0000000000001030","article-title":"Effect of a smart pill bottle reminder intervention on medication adherence, self-efficacy, and depression in breast cancer survivors","volume":"45","author":"Park","journal-title":"Cancer Nurs"},{"issue":"21","key":"R44","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3969\/j.issn.2095-1752.2023.21.023","article-title":"The application effectiveness of a mobile healthcare-based chronic disease management system in cancer patient treatment [Article in Chinese]","volume":"13","author":"Zhao","journal-title":"Journal of Frontiers of Medicine"},{"issue":"7568","key":"R45","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1136\/bmj.333.7568.597","article-title":"The case of the misleading funnel plot","volume":"333","author":"Lau","journal-title":"BMJ"},{"issue":"8","key":"R46","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31756","article-title":"Human-centered design of a personalized digital health intervention to improve oral chemotherapy adherence in adolescents and young adults with hematologic cancers","volume":"72","author":"Psihogios","journal-title":"Pediatr Blood Cancer"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-032-03394-9_19","article-title":"\u0395health literacy, beliefs about medication and adherence in older adults with chronic diseases: a cross-sectional study","volume":"1489","author":"Zisopoulou","journal-title":"Adv Exp Med Biol"},{"issue":"3","key":"R48","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5.3.e19","article-title":"Multimedia formats for patient education and health communication: does user preference matter?","volume":"5","author":"Wiljer","journal-title":"J Med Internet Res"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102432","article-title":"Effectiveness of digital health interventions on blood pressure control, lifestyle behaviours and adherence to medication in patients with hypertension in low-income and middle-income countries: a systematic review and meta-analysis of randomised controlled trials","volume":"69","author":"Boima","journal-title":"EClinicalMedicine"},{"issue":"13","key":"R50","doi-asserted-by":"publisher","DOI":"10.3390\/nu17132200","article-title":"E-health and m-health in obesity management: a systematic review and meta-analysis of RCTs","volume":"17","author":"Chiavarini","journal-title":"Nutrients"},{"issue":"5","key":"R51","doi-asserted-by":"publisher","DOI":"10.2196\/24190","article-title":"Mobile apps to improve medication adherence in cardiovascular disease: systematic review and meta-analysis","volume":"23","author":"Al-Arkee","journal-title":"J Med Internet Res"},{"issue":"6","key":"R52","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1002\/ejsp.674","article-title":"How are habits formed: modelling habit formation in the real world","volume":"40","author":"Lally","journal-title":"Euro J Social Psych"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2025.1502990","article-title":"Evaluating the effect of mobile applications \u201cMy A:Care\u201d and \u201cSmart Coach\u201d on adherence to lipid-lowering treatment in patients with dyslipidemia: a prospective, randomized, open-label clinical study","volume":"7","author":"Pongchaiyakul","journal-title":"Front Digit Health"},{"issue":"2","key":"R54","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s11606-017-4197-5","article-title":"Advantages to using social-behavioral models of medication adherence in research and practice","volume":"33","author":"Amico","journal-title":"J Gen Intern Med"},{"issue":"8","key":"R55","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.7507\/1002-0179.202410248","article-title":"Research progress on the application of \u201cpatient profile\u201d based on big data in the field of nursing [Article in Chinese]","volume":"40","author":"Yuan","journal-title":"West China Medical Journal"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2026\/1\/e85949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:14:02Z","timestamp":1782839642000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e85949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":55,"URL":"https:\/\/doi.org\/10.2196\/85949","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"article-number":"v28i12e85949"}}