Aim
The purpose of this systematic review was to determine the effectiveness of self‐management interventions for older adults with cancer and to determine the effective components of said interventions.
Methods
We conducted a systematic review of self‐management interventions for older adults (65+) with cancer guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement. We conducted an exhaustive search of the following databases: Ageline, AMED, ASSIA, CINAHL, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. We assessed for quality using the Cochrane Risk of Bias tool and Down & Black for quasi‐experimental studies, with data synthesized in a narrative and tabular format.
Results
Sixteen thousand nine hundred and eight‐five titles and abstracts were screened, subsequently 452 full‐text papers were reviewed by two independent reviewers, of which 13 full‐text papers were included in the final review. All self‐management interventions included in this review measured Quality of Life; other outcomes included mood, self‐care activity, supportive care needs, self‐advocacy, pain intensity, and analgesic intake; only one intervention measured frailty. Effective interventions were delivered by a multidisciplinary teams (n = 4), nurses (n = 3), and mental health professionals (n = 1). Self‐management core skills most commonly targeted included: problem solving; behavioural self‐monitoring and tailoring; and settings goals and action planning.
Conclusions
Global calls to action argue for increased emphasize on self‐management but presently, few interventions exist that explicitly target the self‐management needs of older adults with cancer. Future work should focus on explicit pathways to support older adults and their caregivers to prepare for and engage in cancer self‐management processes and behaviours.
Background: Cancer predominates in adults over age 65. Cancer treatments are known to create physical and psychosocial challenges, which may be amplified for older adults with cancer. Learning and applying self-management behaviours and skills during treatment with cancer can help to manage/ recover health and improve quality of life. In many other chronic illnesses, self-management interventions are known to improve health outcomes and lower healthcare costs. The purpose of this systematic review is to determine the effectiveness of self-management interventions for older adults with cancer on physical, psychosocial, and health system-related outcomes. Methods: We are conducting a systematic review of self-management interventions for older adults (65+) diagnosed with cancer (solid tumour or haematological) in the active treatment phase of cancer. This systematic review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Studies are limited to experimental or quasi-experimental methods published in English, French, German, or Dutch. A search strategy was designed with a Health Sciences librarian and performed using the following electronic databases: Ageline, AMED, ASSIA, Cinahl, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. Approximately 14,000 titles and abstracts are being electronically screened by a minimum of 2 reviewers, with relevant studies to be screened for full text. The final sample of included studies will be assessed for quality using the Cochrane Risk of Bias tool and Down and Black for quasi-experimental studies, with data synthesized in a narrative and tabular format. Discussion: This systematic review will expand the knowledge base of interventions supporting self-management for older adults with cancer. This study will inform future intervention development by identifying gaps and strengths in effective self-management interventions targeting the needs of older adults receiving active treatment for cancer. Systematic review registration: PROPERO registry ID# CRD42019134113
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