Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 24, 2022
Open Peer Review Period: May 24, 2022 - Jul 19, 2022
Date Accepted: Nov 13, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mobile Phone Apps for symptom management in Cancer Survivors: A Systematic Review and Meta-analysis of Randomized Controlled Trials
ABSTRACT
Background:
Most cancer patients have psychological or physical distress. This distress can harm their quality of life (QOL). Smartphone application (app) interventions are increasingly being used to improve QOL and psychological outcomes in cancer patients. However, there are still conflicting results in the literature about its effect.
Objective:
This review and meta-analysis investigated the effectiveness of mobile phone app interventions on QOL and psychological outcomes in cancer patients, with a special focus on the format of intervention delivery.
Methods:
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, The Cochrane Library, Embase, CENTRAL, and China National Knowledge Infrastructure (CNKI), to identify studies involving apps focused on cancer survivors and QoL and/or psychological or physical symptom published from inception to 13 January 2022. Only trial studies which met the inclusion criteria were selected. Standardized mean difference (SMD) with a corresponding 95% confidence interval (95% CI) was pooled when needed. Sensitivity analysis and subgroup analysis were also conducted.
Results:
Twenty five RCTs with a total of 3456 participants were included into this meta-analysis. Compared with routine care, app intervention was associated with higher QOL (SMD = 0.45; 95%CI: 0.28, 0.61; p < 0.05), with less anxiety (SMD = -1.04; 95%CI: -1.67, -0.41; P < 0.001), depression (SMD = -0.36; 95%CI: -0.62, -0.11; P < 0.01), distress (SMD = -0.41; 95%CI: -0.72, -0.10; p < 0.01), fatigue (SMD = -0.42; 95% CI: -0.64, -0.20, p < 0.01), and pain (SMD = -0.33; 95% CI: -0.47, -0.19, p < 0.01). However, anxiety and depression score did not differ significantly between the two groups in breast cancer survivors and in didactic format studies.
Conclusions:
Our study shows that mobile apps intervention can improve QOL and alleviate anxiety, depression, distress, fatigue, and pain in cancer patients. However, these results should be recognized cautiously due to between-study heterogeneity, indicating that more methodological and well-designed applied research is needed to understand how to better utilize this digital technology to help cancer patients. Clinical Trial: This review did not require informed consent or ethical approval because the data derived from previously published studies.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.