Agboola, S.O., Ju, W., Elfiky, A., Kvedar, J.C., & Jethwani, K. (2015). The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: A systematic review of randomized controlled trials. Journal of Medical Internet Research, 17, e65. 

STUDY PURPOSE: To review randomized, controlled trials evaluating the effect of telehealth interventions on pain, depression, and health-related quality of life outcomes in cancer care

TYPE OF STUDY: Systematic review

DATABASES USED: PubMed, EMBASE, Google Scholar, CINAHL, and PsychINFO

KEYWORDS: Neoplasms, cancer remote consultation, mHealth, connected health, text messaging, telemedicine, telehealth, ehealth, telephone therapy, teleconsultation, mobile technology, telecare, internet, digital health, mobile phone, smartphone, apps, and mobile application

INCLUSION CRITERIA: Reported the effect of telehealth on pain, depression, or quality of life in patients with cancer; randomized, controlled trials

EXCLUSION CRITERIA: Not stated

TOTAL REFERENCES RETRIEVED: 4,929

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Cochrane Collaboration’s risk of bias tool 

• FINAL NUMBER STUDIES INCLUDED = 20 
• TOTAL PATIENTS INCLUDED IN REVIEW = 3,654
• SAMPLE RANGE ACROSS STUDIES: 25–571 patients 
• KEY SAMPLE CHARACTERISTICS: Patients with cancer, access to telehealth, and smart phones; English-speaking; high-income countries; most were studies of patients with breast cancer

PHASE OF CARE: Multiple phases of care
 
APPLICATIONS: Pediatrics, elder care, and palliative care

Many of the included studies were telephone-based interventions with the interventions provided by professionals or peer counselors. Five studies used a web-based delivery of the intervention. The duration of the interventions ranged from one week to 12 months with a median of 12 weeks. Three studies examined the effect on pain; two of these showed a significant positive effect of the intervention, and one showed no difference between the groups. Nine studies examined the intervention effect on depression; four of these showed positive effect on depression while five showed no significant effect. Eight studies examined quality of life, and one measured well-being.

This review showed mixed results for the effects of technology-based interventions on pain and depression among patients with cancer.

There were few included studies, and most of them were done in high-income populations that were tech-savvy. There was high heterogeneity in the outcomes. Many of the studies had a high or unclear risk of bias.

It may be worthwhile to use telehealth applications with tech-savvy, high-income patients. These types of interventions are worthy of additional study to fully determine the efficacy of these interventions for symptom management.