Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

Abstract

Objectives The objectives of this systematic review were to (a) identify supportive‐care (psychosocial/behavioral, pharmacological, complementary, or alternative) interventions that have been evaluated via randomized controlled trials (RCTs) to improve patient‐reported health‐related quality of life (HRQoL) among adults with brain tumors, (b) evaluate the quality of the intervention studies, and (c) evaluate if developed interventions have been efficacious at improving HRQoL, as compared with control conditions in RCTs. Methods This systematic review was conducted using preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Four databases were searched for RCTs of supportive‐care interventions for adults with brain tumors, primary or metastatic, that included a patient‐reported HRQoL outcome. Quality of the included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results Ten RCTs involving 640 patients with either a primary or metastatic brain tumor investigating supportive‐care interventions with a HRQoL outcome were identified. In terms of quality, three of the studies received a “strong” rating, three received a “moderate” rating, and four of the studies received a “weak” rating. Only two of the interventions (ie, a home‐based psychosocial intervention and individualized acupuncture with standard rehabilitation) demonstrated improvements in HRQoL over control conditions. Conclusions HRQoL is of the utmost importance when treating patients with brain tumors. Yet there is a notable paucity of research to inform clinical decisions and evidence‐based practice. More high‐quality studies of interventions aimed at improving HRQoL are needed.

Acupuncture as a Treatment Within Integrative Health for Palliative Care: A Brief Narrative Review of Evidence and Recommendations

“…19 Improvement across a range of symptoms can significantly influence QoL, and reviews indicate that acupuncture benefits QoL in palliative care. 57,74 Seven articles were found that discuss safety of acupuncture in palliative care. 50,53,60,63,64,68,75 Filshie focuses on addressing safety issues 75 ; the other articles generally conclude that acupuncture can be a safe procedure in palliative care if administered by qualified practitioners, provided key safety issues are addressed, 50,53,63,64,68 similarly for children.…”

Evaluation of a telehealth psychological support intervention for people with primary brain tumour and their family members: Study protocol for a randomised controlled trial

“…In recent international palliative care guidelines for adults with glioma (Pace et al, ), the MAST program was endorsed as showing clinically significant benefits for managing depression, with the quality of evidence rated higher than for pharmacological interventions. Further, in a systematic review of 10 RCTs of interventions for adults with brain tumour (Pan‐Weisz et al, ), MAST was the only psychosocial program associated with significant improvements in QoL relative to control conditions.…”

Feasibility and acceptability of a telehealth platform for delivering the Making Sense of Brain Tumour programme: A mixed-methods pilot study

“…The transition from hospital-based care to the community is a period of heightened vulnerability for psychological distress, as the diverse physical, cognitive and behavioural effects of the illness become more apparent and contact with health professionals diminishes (Ownsworth et al, 2011). Although clinical practice guidelines for oncology emphasize the need to routinely screen people for distress, provide appropriate interventions and follow-up (Jacobsen & Lee, 2015), there is limited research on psychosocial support interventions for individuals with brain tumour and their families (Pan-Weisz et al, 2019). The mode of delivery is a priority consideration given that many experience debilitating physical and cognitive symptoms which affect their eligibility to drive and access community-based support in the usual ways (Halkett et al, 2015).…”

“…In international palliative care guidelines for adults with glioma (Pace et al, 2017), the quality of evidence for the MAST intervention was rated as higher than pharmacological interventions for managing mood disorders. In a subsequent review of supportive care for brain tumour (Pan-Weisz et al, 2019), the MAST programme was found to be the only psychosocial intervention associated with improvements in QoL. Other rehabilitation interventions have shown evidence of gains in cognitive or physical functioning, but these have not extended to improvements in emotional functioning or QoL (Boele et al, 2018;Gehring et al, 2009).…”