Effectiveness of ecological momentary interventions for patients with cancer: a meta-analysis of randomized controlled trials

Abstract

Symptom burden and impaired quality of life (QoL) are major challenges for patients with cancer. Ecological Momentary Interventions (EMIs) offer real-time, context-sensitive, and personalized support, enabling more precise management of patient needs. To explore the effectiveness of EMIs in improving symptoms and QoL in patients with cancer, a systematic review and meta-analysis was conducted. Following PRISMA 2020, a comprehensive search was conducted in nine databases from inception to December 8, 2025. The RoB 2 tool and GRADE were used to assess risk of bias and certainty of evidence, respectively. The R (version 4.4.1) and the “meta” package were used for statistical analysis. A total of 17 studies involving 4,160 randomized participants were included. The results suggested that EMIs may improve depression in patients with cancer, but were not associated with significant improvements in fatigue, pain severity, pain interference, sleep disturbance, anxiety, or QoL. Given the limited certainty and robustness of the available evidence, further adequately powered, allocation-concealed randomized controlled trials with blinded outcome assessment, where feasible, are needed to strengthen the evidence base for EMIs in oncology care.