In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Singleton et al found that electronic health interventions were associated with improved quality of life, distress, self-efficacy, and fatigue vs usual care during or after treatment in patients with breast cancer.
The meta-analysis included 32 randomized studies including a total of 4,790 patients comparing electronic health interventions with usual care. All electronic health interventions were health self-management interventions, most commonly multicomponent websites (including videos, forums, and electronic reminder systems). Quality of life and other measures were assessed by several different validated instruments across studies.
KEY POINTS
- Satisfaction with the intervention was reported by 71% to 100% of patients; 71% to 95% reported that the intervention was useful; 73% to 92% reported that the intervention was easy to use; and 98% to 100% reported that it was easy to understand.
- For websites, patients engaged most with content on living with side effects, coping strategies, healthy living, advice, blogs, and discussion boards.
Key Findings
Electronic health interventions were associated with significant improvements vs usual care in quality of life (standardized mean difference [SMD] = 0.20, 95% confidence interval [CI] = 0.03–0.36), self-efficacy (SMD = 0.45, 95% CI = 0.24–0.65), distress (SMD = –0.41, 95% CI = –0.63 to –0.20), and fatigue (SMD = –0.37, 95% CI = –0.61 to –0.13). No significant differences between groups were observed for anxiety or depressive symptoms.
Patient acceptability of electronic health interventions was assessed in nine trials. Satisfaction with the intervention was reported by 71% to 100% of patients; 71% to 95% reported that the intervention was useful; 73% to 92% reported that the intervention was easy to use; and 98% to 100% reported that it was easy to understand.
Patient engagement (logins, completed modules, and usage tracking) with the electronic health interventions was assessed in 25 studies. Patient completion of modules ranged from 0% to 100%. At least one use of the module was reported by 61% to 100% of patients. A total of nine studies showed that engagement declined over time. For websites, patients engaged most with content on living with side effects, coping strategies, healthy living, advice, blogs, and discussion boards.
The investigators concluded, “Electronic health interventions may provide an acceptable and effective strategy for improving quality of life, distress, self-efficacy, and fatigue among patients with breast cancer.”
Anna C. Singleton, PhD, of the School of Health Sciences, The University of Sydney, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The investigators reported that no specific funding was received for the study. For full disclosures of the study authors, visit ascopubs.org.
