Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta‐analysis

Abstract

Objective:Connected health technologies have the potential to improve access to cancer care and support and reduce costs. We aimed to assess the impacts of interventions delivered using connected health technologies on psychological and quality of life (QoL) outcomes in people living with and beyond cancer. Methods: PUBMED, PsycINFO, Web of Science, and EMBASE were searched using terms relating to (i) cancer, (ii) connected health, and (iii) QoL/psychological wellbeing. Studies were included if they evaluated interventions using connected health technologies and assessed psychological and/or QoL outcomes for adults at any stage of cancer treatment or survivorship. Results: Thirty-seven studies met the inclusion criteria with a total of 8956 participants. Connected health technologies included web-based applications (n = 24), smart applications (n = 12), and wearable devices (n = 1). Studies were heterogeneous in terms of intervention components. We identified five clusters: (i) Psychosocial support and rehabilitation, (ii) psychoeducation and information support, (iii) symptom monitoring, reporting and self-management, (iv) peer and social support, and (v) health coaching and physical activity training. Due to heterogeneity of outcome measures, the meta-analysis included only seven RCTs; pooled mean estimates showed connected health interventions were moderately effective in reducing symptoms of depression (SMD: −0.226, 95% CI −0.303/−0.149) and anxiety (SMD: −0.188, 95% CI: 0.279/−0.0963) compared with usual care. Conclusion: While the considerable heterogeneity observed highlights the need for more rigorous studies to improve reproducibility and efficiency, results suggest that connected health interventions have the potential to improve psychological wellbeing and QoL outcomes in people living with and beyond cancer.K E Y W O R D S cancer, connected health interventions, oncology, psycho-oncology, psychological wellbeing, quality of life This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Effective Behavior Change Techniques in Digital Health Interventions for the Prevention or Management of Noncommunicable Diseases: An Umbrella Review

“…Two systematic reviews [ 45 , 46 ] and three systematic reviews with meta-analysis [ 47–49 ] on DHIs for patients with cancer or cancer survivors (total n = 22,653) were included. Two reviews were of moderate quality [ 45 , 48 ] and three reviews were low quality [ 46 , 47 , 49 ]. The most comprehensive review of RCTs to date [ 47 ] found eHealth interventions were more effective in increasing physical activity (standardized mean difference [SMD] 0.34; 95% CI 0.21–0.48; k = 15), improving dietary behavior (SMD 0.44; 95% CI 0.18–0.70; k = 6) and reducing anxiety (SMD 1.21; 95% CI 0.36–2.07; k = 4) in current or former cancer patients compared with control.…”

“…Significant improvements in moderate to vigorous physical activity (MVPA) were found in a meta-analysis of five RCTs (MD = 49 min per week; 95% CI 16–82; p = .004; k = 5) and reductions in body mass index/weight in a meta-analysis of RCTs and pre–post studies (SMD −0.23; 95% CI −0.41 to −0.05; p = .011; k = 4) [ 48 ]. Another meta-analysis found connected health interventions to be effective in reducing symptoms of depression compared with usual care (SMD −0.226; 95% CI −0.303 to −0.149; I 2 = 0%; k = 7) [ 49 ].…”