Patient-facing mobile health applications for quality of life and treatment adherence during cancer chemotherapy: A systematic review and meta-analysis

Abstract

Background Cancer chemotherapy is associated with significant deterioration in quality of life (QoL) and challenges in treatment adherence. Mobile health (mHealth) applications represent a promising digital intervention for supporting patients throughout the chemotherapy trajectory. Objective To systematically evaluate the effectiveness of patient-facing mHealth applications in improving QoL and treatment adherence among adult cancer patients actively undergoing chemotherapy, and to quantify the pooled effect size through meta-analysis. Methods A systematic search was conducted across seven databases from January 2014 to June 2026. Randomised controlled trials (RCTs), quasi-experimental, and cohort studies enrolling adults receiving chemotherapy with a patient-facing mHealth intervention reporting QoL or adherence outcomes were included. Results Twenty-two studies (n = 3505 participants; 14 RCTs, 5 quasi-experimental, 1 cluster-RCT, 1 protocol) across 11 countries were included. Of 19 studies reporting QoL outcomes, 17 (89%) demonstrated statistically significant improvements in favour of the mHealth intervention. The pooled random-effects estimate demonstrated a large, statistically significant effect on QoL (Hedges’ g = 0.981, 95% CI: 0.336 to 1.626, P = 0.003; k = 9, n = 939). Medication adherence was significantly improved in five studies. Overall certainty of evidence was rated as moderate (GRADE). Conclusions Patient-facing mHealth applications produce large, significant improvements in QoL during cancer chemotherapy. Interventions grounded in nursing theory and incorporating real-time clinician feedback yield the largest effects. Integration of mHealth into oncology pharmacy practice models is warranted. Standardised outcome reporting and head-to-head comparative trials are needed.