Mobile Health Interventions: Examining Medication Adherence Outcomes Among Patients With Cancer.

Only English-language primary studies were included, so non-English evidence was not considered. The 11 studies used different mobile tools, cancer types, treatments, durations, and adherence measures, so it is hard to tell which intervention works best. Many studies were small pilots or not powered to detect effects. Adherence was mostly measured subjectively, and subjective measures can differ from objective measures. There was no standard definition of adherence across studies, so comparison was difficult. Attrition occurred in some Spoelstra studies: 24%, 15%, and 14% were lost to follow-up or withdrew. Samples were overwhelmingly older, white, well educated, and middle to upper economic status, so the results may not apply to all patients. Most studies were conducted in the United States. Interventions often combined reminders, education, symptom assessment, and clinician support, so the effect of any single component cannot be separated. Several positive findings were subgroup-specific, such as race, age, baseline adherence, or anxiety, and not all studies reported how subgroup differences affected adherence.

The authors reported no conflicts of interest.

Do not conclude that mobile reminders reliably improve medication adherence in patients with cancer. The review found mixed results, and several overall comparisons were not statistically significant.