Effects of Interventions on Patient Activation in Adult Patients With Cancer: A Systematic Review and Meta-Analysis...

To systematically review patient activation interventions in adult populations with cancer, identify their key components, and synthesize evidence on the effectiveness of behavioral change-based strategies in enhancing patient activation.

This systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. A comprehensive systematic review was conducted across ten databases (PubMed, CINAHL, Embase, ISI Web of Science, Cochrane Library, Medline, CNKI, Wanfang, VIP, and CBM) to identify randomized controlled trials (RCTs) published between January 2005 and June 5, 2025. The Cochrane Risk of Bias tool was used to evaluate study quality. Meta-analyses were performed using Review Manager 5.3 and Stata 14.0, and sensitivity and subgroup analyses were conducted to examine heterogeneity and assess robustness.` RESULTS: Of 8329 records initially retrieved, 18 RCTs involving 2768 participants met the inclusion criteria. Behavior change interventions produced a statistically significant small-to-moderate effect on patient activation (SMD = 0.32, 95% CI: 0.10-0.53), although with considerable heterogeneity (I² = 86%). Subgroup analyses based on pre-specified variables did not identify the source of heterogeneity.

Behavioral change-based interventions appear effective in enhancing patient activation among adults with cancer. Strategies emphasizing active patient engagement, such as knowledge shaping, goal setting and planning, and feedback and monitoring, were the most frequently employed and showed consistent benefits. Heterogeneity in intervention design limits generalizability. Further rigorous trials are needed to define the optimal components, duration, and intensity for sustained activation outcomes.