A systematic review and meta‐analysis on the effectiveness of web‐based psychosocial interventions among patients with colorectal cancer

Abstract

Aims: To synthesize the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer (CRC). Design: A systematic review and meta-analysis. Data sources: Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021. Review methods: Experimental/quasi-experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed. Results: Nineteen studies consisting of 1386 participants were identified. Cognitivebehavioural therapy delivered online was the most common trialled web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: −0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD −2.23, 95% CI: −3.31 to −1.14, p < .01) and depression (MD −2.84, 95% CI: −4.09 to −1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress. Conclusion: Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings. Impact: By highlighting the potential of web-based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes.

Digital health and telehealth in cancer care: a scoping review of reviews

“…The remaining 134 reviews met eligibility criteria and were included in the synthesis. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 …”

Are digital health interventions valuable to support patients with cancer and caregivers? An umbrella review of web‐based and app‐based supportive care interventions

“…Overall ratings of confidence were applied to the reviews 20 . Therefore, the rating of confidence was high for three reviews, 24,27,34 moderate for 2, 25,28 low for 3, 18,22,35 and critically low for 12 19–21,23,26,29–33,36,37 …”

“…Digital interventions showed mixed results for emotional variables. Even if some studies tended to show a positive effect of these interventions on anxiety (app‐based interventions 21,29 ) and depression (web‐based 19,20,25,30,34 and app‐based 29 interventions), the general tendency was to not observe statistically significant effects 18,19,23,27,29,31,34 . However, regarding psychological distress, studies showed positive effects for both web‐based and app‐based interventions 25–27,29,36 .…”

“…Of the 20 reviews, 12 reported results from both web-based and app-based interventions, 18,20,22,24,[27][28][29][30][32][33][34][35] seven from web-based interventions only, 19,23,25,26,31,36,37 and one from app-based interventions only. 21 Two reviews did not specify the duration of the interventions, 21,37 one did for only one of the interventions (six weeks 20 ), and one was not clear on this point (potentially 6-12 weeks 34 ).…”

“…3.4.6 | Multitargeted or nonspecific interventions Some reviews did not specify the target of the reviewed intervention, forcing a global interpretation of their results. In this context, multitargeted web-based interventions were shown to be efficient in adult patients regarding emotional disorders, including depression (14 studies), 20,25 general and cancer-specific psychological distress (five and four studies, respectively), anxiety (three studies), 25 and symptom distress (three studies), 20 self-efficacy (10 studies), and HRQoL (eight studies). 20,25 A review on caregivers 37 showed efficiency regarding psychological variables (five studies), no significance regarding physical burden (one study), and a deleterious effect of interventions for perceived social support (one study).…”