The Effectiveness of Group-based Self-management Programmes to Improve Physical and Psychological Outcomes in Patients with Cancer: a Systematic Review and Meta-analysis of Randomised Controlled Trials

Abstract

The purpose of this study was to determine if patients with cancer who participate in group-based self-management programmes have better physical and psychological outcomes than patients with cancer who do not participate in group-based self-management programmes. A literature search was conducted in Ovid MEDLINE, Embase, PsycINFO, CINAHL, CENTRAL, Web of Science and ProQUEST using the terms ‘self-management’ OR ‘self-care’ AND ‘cancer’ OR ‘neoplasm’. Randomised controlled trials comparing outcomes for people with cancer participating in group-based self-management programmes with those not participating in these programmes were selected after screening by two reviewers. Initial searches yielded 563 articles. Two reviewers independently extracted data using piloted forms and assessed risk of bias using Cochrane's tool. Standard mean differences were calculated for continuous outcomes. The percentage of variability due to heterogeneity was assessed using I2. A subgroup analysis was carried out where possible. Six trials were included in the review after 141 full-text articles were screened. Group-based self-management programmes were found to improve physical function [standard mean difference (95% confidence interval) = 0.34 (0.02, 0.65), P = 0.04]. No significant results were found between groups for quality of life [0.48 (–0.16, 1.11), P = 0.14] and physical activity level [0.21 (–0.07, 0.5), P = 0.15] outcomes. Group-based self-management programmes for individuals with cancer resulted in improvements in physical outcomes. However, considerable heterogeneity was found between the included studies and the quality of evidence was very low for all main outcomes. Therefore the results should be viewed with caution.