Abstract
ObjectiveThis individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics.MethodsRelevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types.ConclusionsPSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.
Highlights
Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients
Results from individual randomized controlled trials (RCTs) have suggested that younger age, female gender, lower socio‐economic status, having breast cancer compared with lung cancer, cancer recurrence, lower self‐esteem, higher depressive symptoms, and lower self‐efficacy moderate the effects of psychosocial interventions (PSI) in patients with cancer.[15,16,17,18,19]
Meta‐analyses on aggregate data from RCTs have shown that the effects of PSI on psychological well‐being were larger in patients with older age, male gender, lower income, and other types of cancer compared with breast cancer.[6]
Summary
Previous systematic reviews and meta‐analyses from randomized controlled trials (RCTs) have reported that psychosocial interventions (PSI) significantly reduce psychosocial problems and improve the quality of life (QoL), emotional function (EF), and social function (SF) of patients during and after cancer treatment, but effects sizes vary.[1,2,3,4,5,6,7,8,9,10,11,12,13] Better insight into intervention moderators can facilitate identifying and subsequently targeting subgroups of patients with cancer that respond best to a particular type of PSI, thereby improving the intervention effects.[1]
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