Abstract Background Patient nonadherence to chemotherapy remains a significant barrier to effective cancer treatment. Nurse-led educational interventions have been increasingly implemented to address this issue; however, the reported outcomes have been inconsistent. This meta-analysis aims to evaluate the effectiveness of nursing education in improving treatment adherence and related proxy outcomes—such as self-efficacy, symptom burden, and quality of life—among patients undergoing chemotherapy. Method A systematic literature search was conducted across three major electronic databases—PubMed, Web of Science, and Scopus—from inception to June 2025, with additional records identified via Google Scholar. Of 194 records initially retrieved, 19 studies met the eligibility criteria and were included in the meta-analysis. Eligibility criteria encompassed studies involving adult cancer patients receiving chemotherapy, employing randomized controlled trials or quasi-experimental designs, and assessing nurse-led educational interventions on adherence outcomes. Depending on the outcome type, either standardized mean differences (SMDs) or odds ratios (ORs) were calculated using a random-effects model. Results This meta-analysis included 1339 participants from 19 studies. For continuous outcomes, the pooled SMD was 0.89 (95% CI, 0.69–1.09), indicating a substantial positive effect of nurse-led education. For dichotomous outcomes, the pooled OR was 4.37 (95% CI, 1.32–14.49), suggesting that patients receiving educational interventions from nurses were over four times more likely to adhere to treatment. Heterogeneity was minimal ( I 2 = 0%), and no significant publication bias was detected. Notably, face-to-face and digital platform interventions showed significant efficacy in improving direct adherence outcomes, while all modalities positively influenced proxy outcomes such as self-efficacy and quality of life. Conclusion Our meta-analysis suggests that nurse-led educational interventions may significantly improve treatment adherence and associated psychosocial outcomes among chemotherapy patients, although causality cannot be definitively established due to the observational nature of the included studies. These findings support the routine integration of structured nursing education into oncology care to enhance patient engagement and optimize therapeutic outcomes.
Hu et al. (Wed,) studied this question.