The impact of mHealth interventions on medication adherence in breast cancer: a systematic review of randomized controlled trials.

Abstract

Background: Non-adherence to medication can reduce therapeutic effectiveness in breast cancer patients, thereby increasing the risk of disease progression or recurrence. This study aimed to systematically review the existing scientific literature on the impact of mHealth interventions on medication adherence among breast cancer patients.

Methods: This systematic review was conducted following PRISMA guidelines and focused on randomised clinical trials published in English. The review evaluated the effectiveness of mHealth interventions in improving medication adherence in breast cancer patients from their inception through June 2025. The databases searched included PubMed, Medline, Cochrane, and Scopus. Study selection, data extraction, and quality assessment were performed by two independent reviewers using Cochrane Risk-of-Bias version 2. The protocol was registered in the INPLASY database (INPLASY2024100061).

Results: The review included six randomised controlled trials that met the inclusion criteria. Various mHealth interventions were utilised to improve medication adherence among breast cancer patients. Examples included a smart pill bottle connected to the Pillsy mobile application, SMS reminders, text messaging, phone call reminders, and mobile games. Notably, most mHealth interventions were associated with significant improvements in medication adherence compared to traditional healthcare approaches; however, two studies reported no significant adherence benefits from text messaging compared with standard care. Three out of six studies measured adherence using self-administered questionnaires. For quality assessment, all trials demonstrated adequate randomisation techniques, appropriate allocation concealment, and used appropriate analysis to estimate the effect of assignment to intervention.

Conclusion: Breast cancer patients who received mHealth interventions such as SMS reminders, phone call reminders, a smart pill bottle connected to the Pillsy application, and mobile games showed better medication adherence. To implement mHealth interventions, it is crucial to understand key factors that may influence outcomes, including the timing and frequency of interventions, the methods of measuring adherence, patients' preferences, and the duration of intervention assessment.