JMIR Publications

ABSTRACT

Background:

Globally, the burden of cancer on population health is growing. Recent trends such as increasing survival rates result in a need to adapt cancer care to ensure a good care experience and manageable expenditures. E-health is a promising way to increase cancer care quality and support patients and survivors.

Objective:

The aim of this systematic review is twofold. First, to provide an overview of e-health interventions and their characteristics for Dutch cancer patients and survivors. Second, to provide an overview of the empirical evidence regarding the impact of e-health interventions in cancer care on population health, the quality of care and per capita costs (the Triple Aim domains).

Methods:

The electronic databases Web of Science, PubMed, Cochrane and Ovid PsycINFO were searched using three key search themes: e-health interventions, cancer care and the Netherlands. The identified interventions were classified according to predetermined criteria describing intervention characteristics (e.g., type, function and target population). Their impact was subsequently examined using the Triple Aim framework.

Results:

Thirty-eight interventions were identified. Most of these were web portals or web applications, functioning to inform and self-manage, and target psychosocial factors or problems. Few interventions were tailored to age, disease severity or gender. Current results indicated that e-health interventions could positively impact cancer patients’ and survivors’ sleep quality, fatigue, and physical activity. Inconclusive results were found regarding (daily) functioning and quality of life, psychological complaints and psychological adjustment to the disease.

Conclusions:

E-health can improve outcomes in the Triple Aim domains, particularly in the population health and the quality of care domains. Cancer-related pain and common symptoms of active treatment were not targeted in the included interventions and should receive more attention. More research is needed to fully understand the impact of e-health interventions in cancer care on participation, accessibility, and costs. The latter can be examined in economic evaluations comparing e-health interventions with care as usual.