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Quality of life support in advanced cancer—web and technological interventions: systematic review and narrative synthesis
  1. Kathleen Kane1,
  2. Fiona Kennedy1,
  3. Kate L Absolom1,2,
  4. Clare Harley3 and
  5. Galina Velikova1,4
  1. 1Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
  2. 2Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
  3. 3School of Healthcare, University of Leeds, Leeds, UK
  4. 4Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
  1. Correspondence to Kathleen Kane, Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK; um08k2k{at}leeds.ac.uk

Abstract

Background As treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory.

Objectives 1. To examine the features and delivery of web and technological interventions supporting patients with advanced cancer. 2. To explore their efficacy relating to QoL and psychosocial well-being.

Methods Relevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis.

Results Of 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment.

Conclusion While complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer.

PROSPERO registration number CRD42018089153.

  • breast
  • quality of life
  • supportive care

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors All authors contributed to the conception and design of the review. KK drafted the review protocol, which was critically revised by FK, KLA, CH and GV. KK, FK, KLA and CH contributed to the process of study screening and selection. KK extracted and interpreted the data, and assessed the included studies for risk of bias. KK drafted the manuscript. FK, KLA, CH and GV critically revised the manuscript. All authors reviewed and approved the final version of the manuscript.

  • Funding This review has been conducted as part of a wider programme of research funded by Breast Cancer Now (grant reference 2016NovPhD818).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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