Background: As the survival rate of cancer patients increases, the clinical importance of rehabilitation provided by healthcare professionals also increases. However, the evidence supporting the relevance of rehabilitation programs is insufficient. This study aimed to review the literature on effectiveness in physical function, quality of life (QOL) or fatigue of supervised physical rehabilitation in patients with advanced cancer. Methods: A systematic review and meta-analysis was conducted following the Cochrane guidelines. We narratively described the results when meta-analysis was not applicable or appropriate. Literature databases including Ovid-MEDLINE, Ovid-EMBASE, and the Cochrane Library, as well as several Korean domestic databases, were searched up to June 2017 for studies that investigated the effectiveness of supervised physical rehabilitation programs on physical function, QOL or fatigue in patients with advanced cancer. The quality of the selected studies was evaluated independently by paired reviewers. Results: Eleven studies with 922 participants were finally selected among 2,459 articles. The meta-analysis revealed that after physical exercise, the physical activity level and strength of patients with advanced cancer increased significantly. The QOL showed a statistically significant improvement after physical rehabilitation according to the European Organization for Research and Treatment of Cancer version C30. Though some of measurements about cardiovascular endurance or strength in several studies were not able to be synthesized, each study reported that they were significantly improved after receiving rehabilitation. Conclusion: Supervised physical rehabilitation for patients with advanced cancer is effective in improving physical activity, strength, and QOL. However, more trials are needed to prove the effectiveness of supervised exercise and to strengthen the evidence.

Background Digital health technologies have been used to enhance adherence to TB medication, but the cost-effectiveness remains unclear. Methods We used the real data from the study conducted from April 2014 to December 2020 in Morocco using a smart pillbox with a web-based medication monitoring system, called Medication Event Monitoring Systems (MEMS). Cost-effectiveness was evaluated using a decision analysis model including Markov model for Multi-drug resistant (MDR) TB from the health system perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER) per disability adjusted life-year (DALY) averted. Two-way sensitive analysis was done for the treatment success rate between MEMS and standard of care. Results The average total per-patient health system costs for treating a new TB patient under MEMS versus standard of care were $398.70 and $155.70, respectively. The MEMS strategy would reduce the number of drug-susceptible TB cases by 0.17 and MDR-TB cases by 0.01 per patient over five years. The ICER of MEMS was $434/DALY averted relative to standard of care, and was most susceptible to the TB treatment success rate of both strategies followed by the managing cost of MEMS. Conclusion MEMS is considered cost-effective for managing infectious active TB in Morocco.

Background The results of previous experimental studies have been inconsistent in the effect of preoperative education on postoperative outcomes, and there have been no meta-analyses focusing solely on preoperative education for patients with cancer. Objectives To identify the magnitude and direction of the effects of preoperative education and to investigate the influence of moderators on postoperative outcomes for patients undergoing cancer-related surgery. Methods A systematic review and meta-analysis was conducted following the Cochrane guidelines. Electronic databases were searched until October 2019 using Cochrane database, MEDLINE, EMBASE, and CINAHL for randomized controlled trials and quasi-experimental studies on preoperative education interventions. Ten studies with 45 effect sizes were analyzed in this meta-analysis, and the standardized mean difference was calculated based on Hedges’ g as an effect size. Results Meta-analysis showed that the overall effect size of preoperative education was moderate. Preoperative education improved cancer patients’ knowledge and satisfaction and reduced pain. The effects of preoperative education were greater in younger age groups when delivered using verbal or combined educational methods. Conclusion This meta-analysis demonstrated the importance of preoperative educational interventions not only in terms of their surgery-related cognitive aspects but also in terms of the physical and psychological aspects linked to the cancer surgery. Implications for Practice Interventions to provide the most effective preoperative education for patients with cancer in the hospital setting are required, and this information can be used to develop evidence-based education strategies for patients undergoing cancer-related surgery.

Background Poor adherence to tuberculosis (TB) treatment can result in community transmission and drug resistance. Digital health technologies have been used to enhance adherence to TB medication for proper management, but the cost-effectiveness of this approach remains unclear.Methods We used the real data from the study conducted from April 2014 to December 2020 in Morocco to enhance the adherence to drug-susceptible TB treatment using a smart pillbox with a web-based medication monitoring system, called Medication Event Monitoring Systems (MEMS). We applied a Markov model adding Multi-drug resistant (MDR) TB to evaluate the costs and cost-effectiveness of MEMS, compared to the standard of care (modified directly observed treatment and intervention) from the health perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER) per disability adjusted life-year (DALY) averted. We also performed two-way sensitive analysis between treatment success rate of MEMS and standard of care. Results The average total per-patient health system costs for treating a new TB patient under MEMS versus standard of care were $398.7 and $155.7, respectively. The MEMS strategy would reduce the number of drug-susceptible TB cases by 0.17 and MDR-TB cases by 0.01 per patient over five years. The ICER of MEMS was $434/DALY averted relative to standard of care, and was most susceptible to the TB treatment success rate of both strategies followed by the managing cost of MEMS.Conclusion MEMS is considered cost-effective for managing infectious active TB in Morocco.