Effect of mHealth interventions on psychological issues experienced by women diagnosed with breast cancer receiving chemotherapy: A systematic review and meta-analysis

Abstract

Background: A range of psychological issues often accompany breast cancer chemotherapy. Owing to their ubiquity, mobile phones have been used to deliver supportive interventions that address these issues. However, we currently lack sufficient evidence to guide the design of such interventions. Aim: To analyse and synthesise available evidence on the effectiveness of mobile-phone-based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. Methods: A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta-analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. Results: The review included ten published studies which covered 1,548 patients. The meta-analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p = .01, I 2 = 17%). No significant effects were found for anxiety (SMD = -0.01, 95% CI [-0.26, 0.25], p = 0.96, I 2 = 53%) and depression (SMD = 0.02, 95% CI [-0.17, 0.20], p = .87, I 2 = 0%). Individual studies suggest reduced symptom prevalence ( p = .033, d =.27), symptom distress ( p = .004, d = .004), symptom interference ( p = .02, d = . 51),supportive care needs ( p < .05, d = 2.43); improved self-efficacy ( p = .03, d = 0.53), self-esteem ( p <.001, d = 0.87) andemotional functioning ( p = .008, d = .30). The methodological quality ranged from low to moderate. Conclusion: mHealth interventions might be helpful in addressing certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are hereby warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies

Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Subgroup analyses showed that these app-based interventions were effective with durations of <3 months but not with a duration of 3 to 12 months (SMD=−0.25, 95% CI −0.51 to 0.02; P=.07; I 2 =53%). When studies were grouped by type of cancer, 46% (6/13) of the studies involved breast cancer survivors [21][22][23]43,47,48], and mHealth app interventions did not alleviate depression in these survivors (SMD=−0.11, 95% CI −0.27 to 0.06; P=.21). Subgroup analyses according to intervention theory revealed that cognitive behavioral theory-based interventions could effectively relieve depression in cancer survivors (SMD=−0.75, 95% CI −1.42 to 0.09; P=.03), but there was high heterogeneity.…”

“…Although several systematic reviews have addressed the psychological impact of teleinterventions on cancer survivors [21][22][23][24], contradictory results remain. A meta-analysis that included 20 telehealth interventions found that the interventions improved patients' QOL and self-efficacy and reduced depression, distress, and perceived stress.…”

Leveraging Telehealth for the Management of Breast Cancer: A Systematic Review

“…Several forms of telehealth have been used for the last several years in the area of oncology, and specifically breast cancer. mHealth apps have shown effectiveness in improving mood, symptom interference, self-efficacy, self-esteem, and emotional functioning [ 4 ]. mHealth apps provide education and improve health literacy [ 5 , 6 ].…”