This systematic review and meta-analysis evaluated the impact of mHealth interventions on outcomes in pediatric patients with cancer. The analysis included 2645 patients and compared mHealth interventions to usual care. The primary outcomes were not specified, but secondary outcomes included infection rates, PICC complications, quality of life, self-management ability, treatment adherence, PICC catheter displacement, and health knowledge.
Key findings showed that mHealth interventions significantly reduced infection rates (OR 0.25, 95% CI 0.10-0.60, P=.002) and overall incidence of PICC complications (OR 0.16, 95% CI 0.10-0.24, P<.001). Quality of life (SMD 1.34, 95% CI 0.13-2.55, P=.03), self-management ability (SMD 6.39, 95% CI 1.26-11.53, P=.01), and treatment adherence (OR 2.83, 95% CI 1.41-5.66, P=.003) also improved significantly. However, no significant effects were found for PICC catheter displacement (OR 0.44, 95% CI 0.15-1.29, P=.13) or health knowledge (SMD 4.44, 95% CI -2.40 to 11.29, P=.20).
The authors note limitations, including the need for further high-quality studies to verify the impact on catheter displacement and health knowledge. Adverse events and follow-up duration were not reported. Despite these gaps, the findings support the use of mHealth to reduce infections and PICC-related complications while improving quality of life, self-management, and adherence in pediatric cancer patients.
View Original Abstract ↓
BACKGROUND: Cancer poses a significant threat to children's health, and mobile health (mHealth) is emerging as a key tool for remote disease management, health education, and follow-up. However, evidence of its effectiveness remains limited.
OBJECTIVE: This study aimed to summarize the effects of mHealth interventions for pediatric cancer compared with usual care, providing evidence-based support for optimizing intervention models and improving patient outcomes.
METHODS: A systematic search of 14 databases identified randomized controlled trials (RCTs) on mHealth apps for pediatric patients with cancer from inception to August 1, 2025. Two reviewers independently screened studies, extracted data, assessed bias risk, and graded evidence quality. The meta-analysis was conducted using RevMan 5.4 and Stata 15.
RESULTS: A total of 24 RCTs involving 2645 patients were included. This review found that mHealth interventions significantly reduced infection rates (odds ratio [OR] 0.25, 95% CI 0.10-0.60; P=.002) and the overall incidence of peripherally inserted central catheter (PICC) complications (OR 0.16, 95% CI 0.10-0.24; P<.001), while improving quality of life (standardized mean difference [SMD] 1.34, 95% CI 0.13-2.55; P=.03), self-management ability (SMD 6.39, 95% CI 1.26-11.53; P=.01), and treatment adherence (OR 2.83, 95% CI 1.41-5.66; P=.003). However, mHealth interventions had no significant effect on PICC catheter displacement (OR 0.44, 95% CI 0.15-1.29; P=.13) or health knowledge (SMD 4.44, 95% CI -2.40 to 11.29; P=.20). Further high-quality studies are needed to verify their impact in these areas. The intervention components covered 9 behavior change techniques: goals and planning, feedback and monitoring, social support, shaping knowledge, repetition and substitution, reward and threat, comparison of outcomes, natural consequences, and regulation.
CONCLUSIONS: This systematic review and meta-analysis synthesized evidence from RCTs. The findings support the use of mHealth to reduce infections and PICC-related complications among pediatric patients with cancer while improving quality of life, self-management capabilities, and treatment adherence. These results underscore the importance of incorporating mHealth strategies into pediatric cancer care and guide the development and enhancement of future mHealth interventions.