The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review

  • Elizabeth Hernandez SilvaEmail author
  • Sheleigh Lawler
  • Danette Langbecker



Integrating mHealth into the cancer care continuum may be an effective strategy to improve cancer survivorship care by supporting self-management. We aim to assess the effectiveness of mHealth applications (apps) for self-management in improving pain, psychological distress, fatigue, or sleep outcomes in adult cancer survivors.


Experimental quantitative studies evaluating apps aiming to support self-management for adult cancer survivors and reporting pain, psychological distress, fatigue, or sleep outcomes were included. PubMed, Web of Science, Embase, CINAHL, PsycINFO, Scopus, and CENTRAL databases were searched from inception through December 2017. Risk of bias was assessed using the Cochrane risk of bias tool (PROSPERO registration number CRD42017081182).


Seven studies of six mHealth interventions (n = 949 participants) were included. Two randomized controlled trials (RCTs), one quasi-RCT, one non-RCT, and three single-arm studies involved survivors with a mix of cancer types. The most common app features were symptom questionnaires (n = 5) and progress tracking (n = 5). Four studies reported outcomes for pain, with three showing improvements. Two studies reported psychological distress outcomes, showing mixed results. Four studies reported improvements in fatigue post-intervention or in the intervention compared with control group, but the changes were not all statistically significant. Two studies reported improvements in sleep outcomes.


There is emerging evidence that mHealth interventions that support self-management can improve pain and fatigue outcomes in cancer survivors, and some promise for psychological distress and sleep outcomes. Further development and investigation of mHealth is needed, incorporating targeted, evidence-based models of care into app design.

Implications for Cancer Survivors

mHealth interventions can improve outcomes for cancer survivors and have significant potential to benefit this growing population due to their reach.


mHealth Mobile applications Neoplasms Survivorship Self-management 


Compliance with ethical standards

This article does not contain any studies with human participants or animals performed by the authors.

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

11764_2018_730_MOESM1_ESM.docx (34 kb)
ESM 1 (DOCX 33 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Online Health/Centre for Health Services ResearchThe University of QueenslandWoolloongabbaAustralia
  2. 2.Cancer Prevention Research Centre, School of Public HealthThe University of QueenslandHerstonAustralia

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