Evaluating Effectiveness of mHealth Interventions for Rehabilitation in Patients With Head and Neck Cancer:
Yang Xiao1,2, Qiuyu Zhou1,2, Feiruo Hong1,2
1School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Background:
Patients with head and neck cancer (HNC) frequently experience functional impairments and psychological distress following surgery or radiotherapy. While mobile health (mHealth) interventions are increasingly integrated into clinical care to support patient self-management and home-based recovery, evidence of their effectiveness in HNC remains inconsistent.
Objective:
This study aims to evaluate the effectiveness of mHealth interventions on quality of life (QoL), psychological symptoms, physical symptoms, and functional recovery among HNC survivors.
Methods:
This systematic review and meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Overall, 12 electronic databases were searched for randomized controlled trials published up to December 1, 2025. Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2.0 tool. Certainty of evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Pooled effects were calculated as standardized mean differences (SMDs) with 95% CIs. The primary outcome was QoL; secondary outcomes included anxiety, depression, fatigue, pain, swallowing function, and maximal interincisal opening (MIO).
Results:
A total of 26 randomized controlled trials involving 2385 participants were included. mHealth interventions significantly improved QoL (SMD 0.64, 95% CI 0.41-0.88; P<.001), anxiety (SMD -0.75, 95% CI -1.42 to -0.08; P=.03), depression (SMD -0.89, 95% CI -1.37 to -0.40; P<.001), and fatigue (SMD -0.85, 95% CI -1.19 to -0.51; P<.001). Pain showed a small reduction (SMD -0.37, 95% CI -0.49 to -0.24; P<.001). However, the improvement in swallowing function reached only borderline significance (SMD 0.66, 95% CI 0.28-1.04; P=.04), suggesting that current evidence for this outcome is fragile. No significant effect was found for MIO (P=.68). Subgroup analysis revealed that interventions featuring home practice support, self-monitoring, and shorter durations (<3 months) yielded stronger clinical effects. The overall certainty of evidence ranged from low to very low.
Conclusions:
mHealth interventions effectively enhance QoL and alleviate psychosocial distress in patients. However, evidence for improving swallowing function and MIO remains insufficient. Future research should prioritize standardized protocols and high-quality trials to validate long-term clinical value.
