JMIR Publications

ABSTRACT

Background:

Self-management plays an important role in supporting patients’ adaptation to and management of the symptoms of chronic diseases. Cancer is a chronic disease that requires patients to have responsibility in management. Digital technology has the potential to enhance self-management support, but there is little data on what self-management skills are most commonly supported by digital technology.

Objective:

This review examined what were the self-management core skills enabled and supported by digital interventions in people with cancer, and to identify any predictors of effect of digital health intervention on self-management core skills.

Methods:

Three electronic databases (MEDLINE, SCOPUS, and CINAHL) were searched for papers published from January 2011 to February 2022, reporting on randomized controlled trials (RCTs) involving cancer patients/survivors where a digital technology intervention was evaluated and an outcome measured included change in one or more self-management core skills.

Results:

This systematic review resulted in 12 studies that were identified as eligible in identifying what self-management core skills were enabled and supported by digital intervention. The most common self-management core skills targeted by interventions were decision making, goal setting and partnering with health professionals. Eight out of 12 RCTs demonstrated statistically significant improvement in outcomes including self-efficacy, survivorship care knowledge and attitude, quality of life, increased knowledge of treatment and emotional and social functioning. Five out of eight positive RCTs employed theoretical considerations in their study design whereas in one out of four negative RCTs, theoretical considerations were used. Three studies identified the following factors that were associated with improving the development of self-management core skills: younger age (Regression Coefficient [RC] = -0.06, 95% CI = [-0.10,-0.02], P=0.002), male sex (Standard difference [SD] = 0.34 in social functioning, P=0.009), higher education (SD = 0.19 in social functioning, P=0.035), computer literacy (RC = -0.20, 95% CI = [-0.37, -0.03], P=0.024), completing cancer treatment (Cohen’s d = 0.31) and being a recipient of chemotherapy (SD = 0.36 in depression, P = 0.008).

Conclusions:

Digital technology for patients with cancer appears to improve self-management core skills including decision making, goal setting and partnering with healthcare partners. This effect is greater in people who are younger, male, educated, with higher computer literacy, who are completing cancer treatment or who have been a recipient of chemotherapy. Future research should focus on targeting multiple SM core skills and identifying predictors of effect from digital technology intervention.