Abstract
BackgroundDigital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care.ObjectiveThe aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer.MethodsFive databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively.ResultsA total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as high quality.ConclusionsThis review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.
Highlights
Care for patients with cancer extends over a prolonged period, starting with the diagnostic phase, followed by a phase of active treatment and, subsequently, the follow-up phase, or the supportive care phase
This review suggests that Digital self-management support tools (DSMSTs) have a beneficial effect on the quality of life
We have systematically reviewed published randomized controlled trial (RCT) to assess the effectiveness of existing interventions with DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer
Summary
Care for patients with cancer extends over a prolonged period, starting with the diagnostic phase, followed by a phase of active treatment and, subsequently, the follow-up phase (in the curative setting), or the supportive care phase (in the palliative setting). Self-management of chronic disease is challenging for patients, and support from health care professionals is needed. Self-management support is defined as the systematic provision of education and supportive interventions by health care professionals to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support [6]. Nowadays, it is offered through face-to-face contact and via digital tools. Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care
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