Effect of telehealth intervention on breast cancer patients’ quality of life and psychological outcomes: A meta-analysis

Abstract

Introduction Telehealth intervention has been proposed as an innovative intervention approach to breast cancer patients, but there are still conflicting results in the literature about its effect. Methods PubMed, EMBASE, CENTRAL and China National Knowledge Infrastructure (CNKI) were searched from inception to 3 October 2016 for randomized controlled trials (RCTs) which assessed the effect of telehealth intervention versus usual care in breast cancer patients. No language restrictions were used. Standardized mean difference (SMD) with corresponding 95% confidence interval (95% CI) was pooled when needed. Subgroup and sensitivity analyses were conducted if necessary and feasible. Results Twenty RCTs with a total of 2190 participants were included into this meta-analysis. Compared with usual care, telehealth intervention was associated with higher quality of life (SMD = 0.60, 95% CI 0.18-1.01, p = 0.005) and self-efficacy (SMD = 0.59, 95% CI 0.19-0.98, p = 0.003), with less depression (SMD = -1.29, 95% CI -2.28 to -0.30, p = 0.01), distress (SMD = -0.25, 95% CI -0.40 to -0.10, p = 0.001) and perceived stress (SMD = -0.30, 95% CI, -0.59 to -0.02, p = 0.04). However, anxiety score did not differ significantly between the two groups (SMD = -0.09, 95% CI -0.22 to 0.04, p = 0.17). Discussion Telehealth intervention is superior to usual care in breast cancer patients for improved quality of life, higher self-efficacy and less depression, distress, and perceived stress. However, these results should be recognized cautiously due to between-study heterogeneity, indicating that further well-designed RCTs are warranted.

Effectiveness of e‐health based self‐management to improve cancer‐related fatigue, self‐efficacy and quality of life in cancer patients: Systematic review and meta‐analysis

“…Grouping the studies by delivery and duration of interventions did not resolve heterogeneity. Chen et al () reported similar failure on reducing heterogeneity in groups through dividing the studies by delivery and duration of interventions. Similarly, Soon‐Rim and Myung Kyung () reported that control condition might be one of the heterogeneity resources and the e‐health interventions had stronger effects when the controls were designed as usual care or waiting list.…”

“…Some meta‐analyses integrated the overall effect of e‐health interventions (Chen, Guan, Li, & Li, ; Seiler, Klaas, Troster, & Fagundes, ; Soon‐Rim & Myung Kyung, ; Zhang et al, ). However, Soon‐Rim and Myung Kyung () and Zhang et al () focused on telecare, which consisted of a series of medical services, such as interview, health education, and follow‐up.…”

“…These included projects might not be structured and theory‐based. Chen et al () and Seiler et al () measured the effectiveness of telehealth‐based psychological interventions, including CBT, mindfulness, imagery‐based behavioural change, and self‐management. Nevertheless, different clinical effects might exist among several psychological treatments (Nakamura, Lipschitz, Kuhn, Kinney, & Donaldson, ), the mean effect size of psychotherapies is not equal to that of self‐management.…”

Impact of Telehealth Interventions on Processes and Quality of Care for Patients With ESRD

“…However, other research has suggested a possible improvement in QoL using telehealth in patients with breast cancer. 26 Ensuring that high-quality care is maintained through telehealth is also important. The processes of care and surrogate measures for ESRD included in our review varied across studies, ranging from complication control, dialysis adequacy (Kt/V), consultation time, and adherence to scheduled dialysis sessions.…”

Evaluation of a telehealth psychological support intervention for people with primary brain tumour and their family members: Study protocol for a randomised controlled trial

“…Telehealth interventions reduce the need for travel and can improve access to specialist services, and hence decrease disparities in healthcare access (World Health Organization, 2016). Videoconferencing interventions have been found to be beneficial and convenient for the broader cancer population (Cox et al, 2017), and the efficacy of telehealth interventions for improving QoL and psychological outcomes after breast cancer has been demonstrated relative to usual care (see meta-analysis by Chen, Guan, Li, & Li, 2018). However, the efficacy of telehealth interventions for delivering psychosocial support has not been systematically evaluated for the brain tumour population.…”