Supportive eHealth Technologies and Their Effects on Physical Functioning and Quality of Life for People With Lung Cancer: Systematic Review

Abstract

Background: Despite improvements in treatment and early diagnosis people with lung cancer are not living as long as people with other cancers. Therefore, good symptom management and improved quality of life is a priority in this patient group. The more common symptoms of lung cancer; breathlessness, fatigue and depression can be improved by improving patients' physical functioning. However, current health care services have limited capacity to provide this support. One way to address this issue of health care resources is to empower patients to self-manage their condition using electronic health technologies. Objective:The purpose of this review was to locate and assess available research on technologies that support the person with lung cancer to improve or maintain their physical functioning and/or their quality of life.Methods: Six databases (PubMed, Web of Science, CINAHL, Medline, SPORTDiscus and PsychInfo) were searched from January 1990 to April 2023. Studies were suitable for inclusion if; study participants included people with lung cancer over the age of 18, participants were exposed to a physical activity, exercise or a training intervention that was delivered via an electronic or web-based application with or without a comparator. Furthermore, the study must have reported on the impact of the intervention on physical function and/or quality of life. Studies that focused on telemedicine without an online intervention were excluded. The GRADE system was used to assess the quality of included papers. Due to the heterogeneity of the studies a narrative synthesis was undertaken.Results: This review is reported in accordance with the PRISMA guidelines. Seven hundred and ninety-four papers were initially identified through our search; following screening eight papers were confirmed suitable for inclusion in the review. Two papers reported on different stages of the same study therefore only seven studies were included in our analysis. Studies were undertaken between 2010-2018 across multiple countries. Included studies aimed to develop a technology and /or test the technology's feasibility or acceptance. Seven technologies identified included web-based apps, native apps, or gaming consoles. Studies demonstrated impact on walking distance, muscle strength, balance, symptoms of dyspnoea and cancer related fatigue. Quality of life scores also showed improvement. Conclusions:The findings indicate that electronic health apps are generally acceptable to people with lung cancer and can positively impact their physical functioning and wellbeing. However, there are limited studies that demonstrate the impact of these digital interventions over longer periods. None of the studies report on the implementation or adoption of the mobile or electronic health intervention in routine clinical practice highlighting the need for further research in this area. Clinical Trial: Not a trial but has been registered on the PROSPERO data base. Registration number CRD42023414094