Impact of telemonitoring systems in cancer care: a systematic review

This systematic review evaluates the impact, usability, technical performance and adherence of telemonitoring systems in adult cancer care. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Peer Review of Electronic Search Strategies guideline. PubMed, MEDLINE and CINAHL were searched from June 2013 to March 2025. Search terms covered cancer care, telemonitoring systems, mobile health (mHealth), eHealth, health outcomes and evaluation tools. Included studies were randomised controlled trials, controlled clinical trials or prospective trials involving adult patients with cancer using telemonitoring systems for symptom management. Exclusion criteria included cross-sectional, retrospective or non-English studies. Two reviewers screened and extracted data, with a third reviewer resolving disagreements. Risk of bias was assessed using Cochrane Risk of Bias Tool V.1. Due to heterogeneity, a narrative synthesis was conducted, categorising studies by intervention type, clinical outcomes, adherence and usability. 16 studies were included. Telemonitoring appears to hold potential in oncology care, with indications of improved quality of life, symptom management and patient engagement, particularly when real-time clinician feedback is included. While mHealth apps were well received, asynchronous systems were associated with lower adherence. Few studies addressed data security or long-term outcomes. The search was aligned with European Union (EU) - assigned eHealth for Cancer Prevention & Care (eCAN Joint Action) priorities, which may have narrowed the results and limited the overall completeness of this systematic review. Telemonitoring shows promise in oncology care but requires personalisation, workflow integration and long-term evaluation. Real-time clinician support may enhance adherence and outcomes. PROSPERO registration number CRD42023430639.