Can case management improve cancer patients quality of life?

Abstract

Background: Cancer patients are associated with a series of long lasting and stressful treatments and experiencing, and case management (CM) has been widely used and developed with the aim to increase the quality of treatments and improve the patient care services. The purpose of this review is to identify and synthesize the evidence of randomized controlled trial studies to prove that case management could be one way to address the quality of life of cancer patients. Methods: We performed a literature search in 4 electronic bibliographic databases and snowball searches were performed to ensure a complete collection. Two review authors independently extracted and analyzed data. A data extraction form was used to collect the characteristics of case management intervention, report outcomes, and quality assessment. Results: Our searches identified 3080 articles, of which 7 randomized controlled trials met the inclusion criteria. The intervention was varied from the target population, measurement tools, duration of intervention, and so on, and 5 studies consistently showed improvement in the intervention group compared with control groups, no significant difference was found between health care costs of case management care services and the routine care services. Conclusion: There is some evidence that case management can be effective in cancer patients quality of life. However, due to the heterogeneity in the target population, measurement tools, and results applied, no conclusion can be made from a meta-analysis on the present bias. More rigorously multi-centered randomized controlled studies should be provided with detailed information about intervention in future research.

The effectiveness of case management for cancer patients: an umbrella review

“…This is a common issue faced the included reviews. Five of the eight reviews failed to conduct meta-analysis due to the heterogeneity [9,11,19,23,24]. Joo and Huber [22] conducted a review of reviews on the effect of CM on health care utilization outcome of chronic illness patients, they recognized the same problem and suggested using valid and standardized tools to minimize the differences in measurements.…”

“…Joo et al [9] found that CM interventions improved QoL of cancer patients. Yin and colleagues [24] revealed that cancer patients achieved better physical and psychological condition through symptom management, needs assessment, direct referrals, and other services in CM. However, summarized results in our review show that the CM had equivocal effect on cancer patients' global QoL and dimensions including psychological, physical, role, emotional and social function.…”

“…Despite CM interventions share similar definitions and principles [8]. It is hard to foresee which aspect(s) of CM interventions contribute to certain effects due to their comprehensiveness [24].…”

“…Three of the studies were a systematic review with meta-analysis [10,25,26]. Five of the eight reviews adhered to the PRISMA statement [11,19,[24][25][26], two adopted Cochrane systematic review methodology [9,10].…”

“…As shown in Table 2, three studies reviewed trials of nurse-led CM interventions [9,25,26], two reviewed CM-like interventions that not termed as 'CM' while meet the CM definition by the CMSA [8,23,24]. Only one study reviewed CM focus solely on skill-training or symptom management [19].…”