Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 30, 2020
Date Accepted: May 24, 2021
Digital self-management support interventions in the care plan of cancer patients: a review of Randomized Controlled Trials
ABSTRACT
Background:
Digital self-management support tools (DSMST) - electronic devices or monitoring systems to monitor or improve health status - become increasingly important in cancer care.
Objective:
We aimed to analyze published RCTs to assess the effectiveness of existing interventions with DSMST for cancer patients.
Methods:
Five databases were searched from January 2013 through January 2020. English or Dutch language RCTs comparing DSMST to no intervention/usual care/alternative interventions/or a combination, and including patients > 18 years of age with pathologically proven cancer in the active treatment or survivorship phases were included. Results were summarized in a qualitative way.
Results:
19 publications were included, describing three types of DSMST. Although the content, duration and frequency of interventions varied considerably across studies, commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in five studies, on anxiety and depression in three studies, on symptom distress in six studies, on physical activity in three studies, on dietary behavior in one study, and on fatigue in two studies. Also, significant negative effects were observed on anxiety in one study. Other studies reported no significant effects on these outcomes. Most interventions were web-based, two studies used mobile apps, and one study used a game as DSMST.
Conclusions:
This review suggests that DSMST have a beneficial effect on the quality of life, anxiety and depression, symptom distress, physical activity, dietary behavior and fatigue. For effects on other patient outcomes, the evidence is inconsistent, limited, or suggests no effect. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effect of specific interventions in different stages of disease progression, and tailored to individual patients’ needs.
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