Electronic Health Interventions for Patients With Breast Cancer: Systematic Review and Meta-Analyses

Abstract

PURPOSE Ongoing supportive care using electronic health (eHealth) interventions has the potential to provide remote support and improve health outcomes for patients with breast cancer. This study aimed to evaluate the effectiveness of eHealth interventions on patient-reported outcomes (quality of life [QOL], self-efficacy, and mental or physical health) for patients during and after breast cancer treatment and patient-reported experience measures (acceptability and engagement). METHODS Systematic review with meta-analyses (random-effects model) of randomized controlled trials was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Nine databases were searched using a prespecified search strategy. Patient-directed eHealth interventions for adult patients during or after active breast cancer treatment measuring QOL, self-efficacy, and mental (depressive, anxiety, and distress symptoms) or physical (physical activity, nutrition, and fatigue) health outcomes were included. Data from eligible full-text articles were independently extracted by six observers. RESULTS Thirty-two unique studies (4,790 patients) were included. All were health self-management interventions, and most were multicomponent (videos, forums, and electronic reminder systems) websites. Meta-analyses revealed a significant effect of eHealth interventions on QOL (standardized mean difference [SMD], 0.20 [95% CI, 0.03 to 0.36]), self-efficacy (SMD, 0.45 [95% CI, 0.24 to 0.65]), distress (SMD, –0.41 [95% CI,–0.63 to –0.20]), and fatigue (SMD, –0.37 [95% CI, –0.61 to –0.13]). Twenty-five studies (78.1%) measured patient-reported experience measures. Acceptability (n = 9) was high, with high ratings for satisfaction (range, 71%-100%), usefulness (range, 71%-95%), and ease-of-use (range, 73%-92%). Engagement (n = 25) decreased over time, but disease-focused information and interactive support were most engaging. CONCLUSION eHealth interventions may provide an acceptable and effective strategy for improving QOL, distress, self-efficacy, and fatigue among patients with breast cancer.

A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention

“…BC patients are known to be one of the most active populations regarding their disease. As has been highlighted, medical information is one of the most important areas to consider [ 39 , 40 ], and we also saw that its access decreased more gradually, since many of the patients were receiving aggressive medical treatments during 3 to 9 months. Finally, it should be noted that the interest in physical appearance showed a small peak at 9–12 months, which could be explained by many factors.…”

“…Hongru Lu et al [ 38 ], in the synthesis about information needs of BC patients, detailed that 94% of the studies reported that patients were concerned about treatment information, such as intervention procedures, side effects and preoperative procedures. In general, disease-focused information are the most engaging type of information [ 39 , 40 ]. Hongru Lu et al [ 38 ] also pointed out that doctors do not pay enough attention to the emotional pressure that patients feel during the diagnosis and treatment, remarking the need to address this kind of information.…”

Telemedicine Interventions as an Attempt to Improve the Mental Health of Populations during the COVID-19 Pandemic—A Narrative Review

“…The high heterogeneity may also have influenced the results of the meta-analysis; however, the authors indicated a statistically significant efficacy of VCBT, highlighting the limited number of studies on specific psychiatric and somatic conditions [ 45 ]. Moreover, the need for greater research on the effectiveness of remote mental health support methods is widely suggested [ 46 , 47 , 48 ]. It should be emphasised, however, that there is a continued need to adopt remote mental health services or settings in different countries to strengthen practice and assistance during, as well as after, a global pandemic.…”

Identification of tumor antigens and immune subtypes in breast cancer for mRNA vaccine development

“…Worldwide, the “pink killer” breast cancer (BC) represents about 30% of cancers in women, with a high mortality ( 1 ). The cost of surgery, hospitalization, loss of productivity, and emotional trauma place a heavy burden on the patient’s follow-up and treatment, as well as adding insecurity and economic burden to society ( 2 ). There are multiple subtypes of BC, classified according to their gene expression profiles.…”