Effectiveness of Mobile Health for Improving Medication Adherence in Patients With Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: 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. Objective: We aimed to evaluate the effect of mHealth on improving medication adherence among patients with cancer. Methods: 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. Results: 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; P=.002), medication adherence scores (SMD 1.01, 95% CI 0.51-1.52; P=.001), self-efficacy (SMD 0.90, 95% CI 0.29-1.51; P=.01), and service satisfaction while reducing symptom burden (SMD -0.38, 95% CI -0.61 to -0.14; P=.008). However, mHealth had no significant effect on health literacy (SMD 0.51, 95% CI -1.50 to 2.52; P=.29). Subgroup analysis revealed that interventions lasting