(022) Impact of Mobile Health (mHealth) Technologies on Medication Adherence and Symptoms Improvement in Patients Receiving Oral Anti-Cancer Agents: A Systematic Review

Background: The use of oral anticancer agents (OACA) has increased substantially as cancer care shifted from parenteral chemotherapy to oral cancer therapies in the past decade. This shift in cancer care introduced new challenges including medications adherence and symptoms management. The available evidence reveals that OACA adherence ranges from 16% to 100%. Poor adherence to OACA was associated with worse disease outcomes. Mobile health (mHealth) technologies have emerged recently as a method to improve adherence and health outcomes in cancer patients.

Objectives: This systematic review aimed to assess the impact of mHealth technologies (short messaging services, phone calls, and mobile apps) on medication adherence and symptoms improvement among patients taking OACA.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, three databases (PubMed, Cochrane, EMBASE) and reference lists of included articles were thoroughly searched. Randomized controlled trials (RCTs) published in English language from inception until February 2023 that investigated the impact of mHealth technologies on OACA adherence and symptoms improvement were reviewed. Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the Cochrane’s Risk of Bias Tool. The outcomes of interest were OACA adherence and symptoms improvements.

Results: 545 records were identified from the search, and 510 abstracts were screened. A full-text review was conducted for 10 studies, and 6 studies were included in this review. Six RCTs with 788 participants were included. Six RCTs evaluated OACA adherence and five RCTs evaluated symptoms improvements. Of the six studies that assessed the effect of mHealth technologies on OACA adherence, only one found statistically significant improvement. One study out of the five studies found that the intervention significantly improved cancer-related symptoms.

Conclusions: Overall, the findings indicate that mHealth technologies do not significantly improve adherence to OACA or cancer-related symptoms among cancer patients. However, future high-quality studies with larger sample size are needed to reach a definite conclusion.