Electronic health interventions for patients with breast cancer: systematic review and meta-analyses

Anna C. Singleton; Rebecca Raeside; Karice K. Hyun; Stephanie R. Partridge; Gian Luca Di Tanna; Nashid Hafiz; Qiang Tu; Justin Tat-Ko; Stephanie Che Mun Sum; Kerry A. Sherman; Elisabeth Elder; Julie Redfern

doi:10.1200/JCO.21.01171

Electronic health interventions for patients with breast cancer: systematic review and meta-analyses

Anna C. Singleton^*, Rebecca Raeside, Karice K. Hyun, Stephanie R. Partridge, Gian Luca Di Tanna, Nashid Hafiz, Qiang Tu, Justin Tat-Ko, Stephanie Che Mun Sum, Kerry A. Sherman, Elisabeth Elder, Julie Redfern

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

110 Citations (Scopus)

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Abstract

PURPOSE: Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement).

METHODS: Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers.

RESULTS: Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95% CI, 0.24 to 0.65]), distress (SMD, -0.41 [95% CI,-0.63 to -0.20]), and fatigue (SMD, -0.37 [95% CI, -0.61 to -0.13]). Twenty-five studies (78.1%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71%-100%), usefulness (range, 71%-95%), and ease-of-use (range, 73%-92%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging.

CONCLUSION: eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.

Original language	English
Pages (from-to)	2257-2270
Number of pages	15
Journal	Journal of Clinical Oncology
Volume	40
Issue number	20
Early online date	2 May 2022
DOIs	https://doi.org/10.1200/JCO.21.01171
Publication status	Published - 10 Jul 2022

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Copyright American Society of Clinical Oncology 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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@article{15382c4b3c1e427081e80f994c296ee5,

title = "Electronic health interventions for patients with breast cancer: systematic review and meta-analyses",

abstract = "PURPOSE: Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement).METHODS: Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers.RESULTS: Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95\% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95\% CI, 0.24 to 0.65]), distress (SMD, -0.41 [95\% CI,-0.63 to -0.20]), and fatigue (SMD, -0.37 [95\% CI, -0.61 to -0.13]). Twenty-five studies (78.1\%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71\%-100\%), usefulness (range, 71\%-95\%), and ease-of-use (range, 73\%-92\%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging.CONCLUSION: eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.",

author = "Singleton, \{Anna C.\} and Rebecca Raeside and Hyun, \{Karice K.\} and Partridge, \{Stephanie R.\} and \{Di Tanna\}, \{Gian Luca\} and Nashid Hafiz and Qiang Tu and Justin Tat-Ko and Sum, \{Stephanie Che Mun\} and Sherman, \{Kerry A.\} and Elisabeth Elder and Julie Redfern",

note = "Copyright American Society of Clinical Oncology 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2022",

month = jul,

day = "10",

doi = "10.1200/JCO.21.01171",

language = "English",

volume = "40",

pages = "2257--2270",

journal = "Journal of Clinical Oncology",

issn = "1527-7755",

publisher = "American Society of Clinical Oncology",

number = "20",

}

TY - JOUR

T1 - Electronic health interventions for patients with breast cancer

T2 - systematic review and meta-analyses

AU - Singleton, Anna C.

AU - Raeside, Rebecca

AU - Hyun, Karice K.

AU - Partridge, Stephanie R.

AU - Di Tanna, Gian Luca

AU - Hafiz, Nashid

AU - Tu, Qiang

AU - Tat-Ko, Justin

AU - Sum, Stephanie Che Mun

AU - Sherman, Kerry A.

AU - Elder, Elisabeth

AU - Redfern, Julie

N1 - Copyright American Society of Clinical Oncology 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2022/7/10

Y1 - 2022/7/10

N2 - PURPOSE: Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement).METHODS: Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers.RESULTS: Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95% CI, 0.24 to 0.65]), distress (SMD, -0.41 [95% CI,-0.63 to -0.20]), and fatigue (SMD, -0.37 [95% CI, -0.61 to -0.13]). Twenty-five studies (78.1%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71%-100%), usefulness (range, 71%-95%), and ease-of-use (range, 73%-92%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging.CONCLUSION: eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.

AB - PURPOSE: Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement).METHODS: Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers.RESULTS: Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95% CI, 0.24 to 0.65]), distress (SMD, -0.41 [95% CI,-0.63 to -0.20]), and fatigue (SMD, -0.37 [95% CI, -0.61 to -0.13]). Twenty-five studies (78.1%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71%-100%), usefulness (range, 71%-95%), and ease-of-use (range, 73%-92%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging.CONCLUSION: eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.

UR - https://www.scopus.com/pages/publications/85131142768

U2 - 10.1200/JCO.21.01171

DO - 10.1200/JCO.21.01171

M3 - Review article

C2 - 35500200

SN - 1527-7755

VL - 40

SP - 2257

EP - 2270

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 20

ER -

Electronic health interventions for patients with breast cancer: systematic review and meta-analyses

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