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The efficacy of web or mobile-based interventions to alleviate emotional symptoms in people with advanced cancer: a systematic review and meta-analysis

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Abstract

Purpose

This review aims to critically evaluate the efficacy of web or mobile-based (WMB) interventions impacting emotional symptoms in patients with advanced cancer.

Method

Articles published from 1991 to 2019 were identified using PubMed, PsycINFO, CINAHL, and Scopus. Only interventions involving adults with advanced cancer using a WMB intervention to manage emotional symptoms were included. Risk of bias was assessed using ROBINS-I and ROB2 tools. Studies that reported mean symptom scores were pooled using a random-effects model, and standardized mean difference (SMD) and 95% CIs were calculated.

Results

Twenty-three of the 1177 screened studies met the inclusion criteria, and a total sample of 2558 patients were included. The sample was 57% female, and 33% had advanced cancer with mean age of 57.15 years. Thirteen studies evaluated anxiety, nineteen evaluated depression, and eleven evaluated distress. Intervention components included general information, tracking, communication, multimedia choice, interactive online activities, tailoring/feedback, symptom management support content, and self-monitoring. Overall pooled results showed that WMB interventions’ effects on decreasing anxiety (SMD − 0.20, − 0.45 to 0.05, I2 = 72%), depression (SMD − 0.10, − 0.30 to 0.11, I2 = 73%), and distress (SMD − 0.20, − 0.47 to 0.06, I2 = 60%) were not significant for randomized controlled trials (RCTs). In contrast, WMB interventions significantly decreased symptoms of anxiety (p = .002) in a sub-group analysis of non-RCTs.

Conclusion

This meta-analysis demonstrated that WMB interventions were not efficacious in alleviating emotional symptoms in adults with advanced cancer. Considering the diversity of interventions, the efficacy of WMB interventions and its impacts on emotional symptoms should be further explored.

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Data availability

All data presented here are available from the authors on reasonable request.

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Acknowledgements

We would like to thank Jennifer DeBerg, a medical librarian at the University of Iowa Hardin Library for Health Sciences, for helping with the development of the search strategy for all web databases used for this study.

Funding

No funding was received for this work.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Iowa Carver College of Medicine, Newton Road, Iowa City, IA, 52242, USA

    Vijayvardhan Kamalumpundi & Rajeshwari Nair

  2. School of Nursing, University of Wisconsin–Madison, Madison, WI, USA

    Seyedehtanaz Saeidzadeh

  3. College of Nursing, University of Iowa, Iowa City, IA, USA

    Nai-Ching Chi & Stephanie Gilbertson-White

  4. The Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Healthcare System, Iowa City, IA, USA

    Rajeshwari Nair

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  1. Vijayvardhan Kamalumpundi
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  4. Rajeshwari Nair
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  5. Stephanie Gilbertson-White
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Contributions

S.S. developed the study protocol and both S.S. and V.K. led the literature search, data analysis, interpretation, and writing. N.C. and S.S. reviewed studies for Risk of Bias analysis. V.K., S.S., S.G.W., and N.C. reviewed articles for inclusion, and R.N. assisted with interpretation of data for the meta-analysis and analysis of publication bias. All authors participated in the writing and editing of several versions of this manuscript.

Corresponding author

Correspondence to Stephanie Gilbertson-White.

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Vijayvardhan Kamalumpundi and Seyedehtanaz Saeidzadeh contributed equally to this work.

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Kamalumpundi, V., Saeidzadeh, S., Chi, NC. et al. The efficacy of web or mobile-based interventions to alleviate emotional symptoms in people with advanced cancer: a systematic review and meta-analysis. Support Care Cancer 30, 3029–3042 (2022). https://doi.org/10.1007/s00520-021-06496-z

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