Top

Supportive Care in Cancer

Published in:

01-02-2018 | Review Article

Effects of web-based interventions on cancer patients’ symptoms: review of randomized trials

Authors: N. Fridriksdottir, S. Gunnarsdottir, S. Zoëga, B. Ingadottir, E. J. G. Hafsteinsdottir

Published in: Supportive Care in Cancer | Issue 2/2018

Abstract

Purpose

Symptom management is of high priority in cancer care. Information and communication technology allows interventions to be provided through the internet to enhance the delivery of care. This study aimed to review the effects of web-based interventions on cancer patients’ symptoms.

Methods

MEDLINE, PSychINFO, PubMed, CINAHL, and Cochrane databases were systematically searched. Included were randomized controlled trials (RCTs), pilot RCTs, or quasi-experimental (QE) studies focusing on web-based interventions in adult cancer patients with at least one outcome primary or secondary, in terms of symptoms, treatment side effects, or distress. Data were analyzed study by study.

Results

Twenty studies were identified. All web interventions included information, 16 included self-management support, 14 included self-monitoring, 13 included feedback/tailored information, 12 used communication with health-care professionals, and eight used communication with other patients. Overall, 13 studies reported positive symptom outcomes. Psychological distress was reported in eight studies with positive intervention effects in three. Symptoms of anxiety/depression were reported in ten studies with positive intervention effects in five. Somatic symptom severity was reported in ten studies with intervention effects found in six, and symptom distress was reported in six studies with intervention effects found in all.

Conclusions

This review shows the promising potential of web-based interventions for cancer symptom management, although it was limited by considerable heterogeneity in the interventions tested and targeted outcomes. The multidimensional nature of symptoms was partly addressed; only one study was guided by a comprehensive theoretical model of cancer symptom management. It can only be speculated which web elements are important for effective symptom outcomes. Further testing is needed for web-based cancer symptom management.

Teunissen SC, Wesker W, Kruitwagen C, de Haes HC, Voest EE, de Graeff A (2007) Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manag 34:94–104. https://doi.org/10.1016/j.jpainsymman.2006.10.015 CrossRef

Yamagishi A, Morita T, Miyashita M, Kimura F (2009) Symptom prevalence and longitudinal follow-up in cancer outpatients receiving chemotherapy. J Pain Symptom Manag 37:823–830. https://doi.org/10.1016/j.jpainsymman.2008.04.015 CrossRef

Kroenke K, Johns S, Theobald D, Wu J, Wanzhu T (2013) Somatic symptoms in cancer patients’ trajectory over 12 months and impact on functional status and disability. Support Care Cancer 21:765–773. https://doi.org/10.1007/s00520-012-1578-5 CrossRefPubMed

Hofsö K, Rustöen T, Cooper B, Bjordal K, Miaskowski C (2013) Changes over time in occuerrence, severity and distress of common symptoms during and after radiation therapy for breast cancer. J Pain Symptom Manag 45:980–1006. https://doi.org/10.1016/j.jpainsymman.2012.06.003 CrossRef

Kang JH, KwonJH HD, Yennurajalingam S, Bruera E (2013) Changes in symptom intensity among cancer patients receiving outpatient palliative care. J Pain Symptom Manag 45:652–660. https://doi.org/10.1016/j.jpainsymman.2012.11.009 CrossRef

Skerman H, Yates P, Battistutta D (2012) Cancer-related symptom clusters for symptom management outpatients after commencing adjuvant chemotherapy, at 6 months, and 12 months. Support Care Cancer 20:95–105. https://doi.org/10.1007/s00520-010-1070-z CrossRefPubMed

Reilly CM, Bruner DW, Mitchell S, Minasian L, Basch E, Dueck A, Cella D, Reeve BB (2013) A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment. Support Care Cancer 21:1525–1550. https://doi.org/10.1007/s00520-012-1688-0 CrossRefPubMedPubMedCentral

McCurdy MT, Shanholtz CB (2012) Oncologic emergencies. Crit Care Med 40:2012–2222. https://doi.org/10.1097/CCM.0b013e31824e1865 CrossRef

Shi Q, Smith TG, Michnoski JD, Stein KD, Kaw C, Cleeland CS (2011) Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s studies of cancer survivors. Cancer 117:2779–2790. https://doi.org/10.1002/cncr.26146 CrossRefPubMedPubMedCentral

10.

Wu HS, Harden JK (2015) Symptom burden and quality of life in survivorship. A review of the literature. Cancer Nurs 38:E29–E54. https://doi.org/10.1097/NCC.0000000000000135 CrossRefPubMed

11.

World Health Organization (2016). WHO definition of palliative care http://www.who.int/cancer/palliative/definition/en/. Accessed 7 Sept 2016

12.

American College of Surgeons (2016) Commission on Cancer. Cancer program standards: ensuring patient-centered care. Available at: https://www.facs.org/quality%20programs/cancer/coc/standards. Accessed 1 Sept 2016

13.

Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, Lee K, Miaskowski C, Puntillo K, Rankin S, Taylor D (2001) Advancing the science of symptom management. J Adv Nurs 33:668–676CrossRefPubMed

14.

Armstrong TS (2003) Symptoms experience: a concept analysis. Oncol Nurs Forum 30:601–606CrossRefPubMed

15.

Brant JM, Beck S, Miaskowski C (2010) Building dynamic models and theories to advance the science of symptom management research. J Adv Nurs 66:228–240. https://doi.org/10.1111/j.1365-2648.2009.05179.x CrossRefPubMed

16.

Hoffman AJ (2013) Enhancing self-efficacy for optimized patient outcomes through the theory of symptom self-management. Cancer Nurs 36:E16–E26. https://doi.org/10.1097/NCC.0b013e31824a730a CrossRefPubMedPubMedCentral

17.

Ward S, Donovan H, Gunnarsdottir S, Serlin RC, Shapiro GR, Hughes S (2008) A randomized trial of a representational intervention to decrease cancer pain (RIDcancerPain). Health Psychol 27:59–67. https://doi.org/10.1037/0278-6133.27.1.59 CrossRefPubMedPubMedCentral

18.

Berry DL (2011) Patient-reported symptoms and quality of life integrated into clinical cancer care. Semin Oncol Nurs 27:203–210. https://doi.org/10.1016/j.soncn.2011.04.005 CrossRefPubMedPubMedCentral

19.

Kleiboer A, Gowing K, Holm Hansen C, Hibberd C, Hodges L, Walker J, Thekkumpurath P, O’Connor M, Murray G, Sharpe M (2010) Monitoring symptoms at home: what methods would cancer patients be comfortable using. Qual Life Res 19:965–968. https://doi.org/10.1007/s11136-010-9662-0 CrossRefPubMed

20.

American Society of Clinical Oncology (2016) The state of cancer care in America, 2016: a report by the American Society of Clinical Oncology. J Oncol Pract 12:339–383. https://doi.org/10.1200/JOP.2015.010462 CrossRefPubMedCentral

21.

Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17:1117–1128. https://doi.org/10.1007/s00520-009-0615-5 CrossRefPubMed

22.

Puts MT, Papoutsis A, Springall E, Tourangeau AE (2012) A systematic review of unmet needs of newly diagnosed older cancer patients undergoing active treatment. Support Care Cancer 20:1377–1394. https://doi.org/10.1007/s00520-012-1450-7 CrossRefPubMed

23.

King AJ, Evans M, Moore TH, Paterson C, Sharp D, Persad R, Huntley AL (2015) Prostate cancer and supportive care: a systematic review and qualitative synthesis of men’s experiences and unmet needs. Eur J Cancer Care (Engl) 24:618–634. https://doi.org/10.1111/ecc.12286 CrossRef

24.

Maguire R, Kotronoulas G, Simpson M, Paterson C (2015) A systematic review of the supportive care needs of women living with and beyond cervical cancer. Gynecol Oncol 136:478–490. https://doi.org/10.1016/j.ygyno.2014.10.030 CrossRefPubMed

25.

Pereira J, Green E, Molloy S, Dudgeon D, Howell D, Krzyzanowska MK, Mahase W, Tabing R, Urowitz S, Macdougall L (2014) Population-based standardized symptom screening: Cancer Care Ontario’s Edmonton symptom assessment system and performance status initiative. J Oncol Pract 10:212–214. https://doi.org/10.1200/JOP.2014.001390 CrossRefPubMed

26.

McCorkle R, Ercolano E, Lazenby M, Shulman-Green D, Schilling LS, Lorig K, Wagner EH (2011) Self-management: enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin 61:50–62. https://doi.org/10.3322/caac.20093 CrossRefPubMedPubMedCentral

27.

Coolbrandt A, Wildiers H, Aertgeerts B, Van der Elst E, Laenen A, Dierckx de Casterle D, van Achterberg T, Milisen K (2014) Characteristics and effectiveness of complex nursing interventions aimed at reducing symptom burden in adult patients treated with chemotherapy: a systematic review of randomized controlled trials. Int J Nurs Stud 51:495–510. https://doi.org/10.1016/j.ijnurstu.2013.08.008 CrossRefPubMed

28.

Clauser SB, Wagner EH, Aiello Bowles EJ, Tuzzio L, Greene SM (2011) Improving modern cancer care through information technology. Am J Prev Med 40:S198–S207. https://doi.org/10.1016/j.amepre.2011.01.014 CrossRefPubMedPubMedCentral

29.

Barak A, Klein B, Proudfoot JG (2009) Defining internet-supported therapeutic interventions. Ann Behav Med 38:4–17. https://doi.org/10.1007/s12160-009-9130-7 CrossRefPubMed

30.

Murray E (2012) Web-based interventions for behavior change and self-management: potential, pitfalls, and progress. Med 2.0 14:e3. https://doi.org/10.2196/med20.174 CrossRef

31.

Slev VN, Mistiaen P, Pasman HR, Verdonck-de Leeuw IM, van Uden-Kraan CF, Francke AL (2016) Effects of eHealth for patients and informal caregivers confronted with cancer: a meta-review. Int J Med Inform 87:54–67. https://doi.org/10.1016/j.ijmedinf.2015.12.013 CrossRefPubMed

32.

Jansen F, van Uden-Kraan C, van Zwieten V, Witte BI, Verdonck-deLeeuw IM (2015) Cancer surviors’perceived need for supportive care and their attitude towards self-management and eHealth. Support Care Cancer 23:1679–1688. https://doi.org/10.1007/s00520-014-2514-7 CrossRefPubMed

33.

van de Poll-Franse LV, van Eenbergen MC (2008) Internet use by cancer survivors: current use and future wishes. Support Care Cancer 16:1189–1195. https://doi.org/10.1007/s00520-008-0419-z CrossRefPubMed

34.

Ryhänen AM, Siekkinen M, Rankinen S, Korvenranta H, Leino-Kilpi H (2010) The effects of internet or interactive computer-based patient education in the field of breast cancer: a systematic review. Patient Educ Couns 79:5–13. https://doi.org/10.1016/j.pec.2009.08.005 CrossRefPubMed

35.

Salonen A, Ryhänen AM, Leino-Kilpi H (2014) Educational benefits of internet and computer-based programmes for prostate cancer patients: a systematic review. Patient Educ Couns 94:10–19. https://doi.org/10.1016/j.pec.2013.08.022 CrossRefPubMed

36.

Ventura F, Ohlén J, Koinberg I (2013) An integrative review of supportive e-health programs in cancer care. Eur J Oncol Nurs 17:498–507. https://doi.org/10.1016/j.ejon.2012.10.007 CrossRefPubMed

37.

Bennett AV, Jensen RE, Basch E (2012) Electronic patient-reported outcome systems in oncology clinical practice. CA Cancer J Clin 62:336–3347. https://doi.org/10.3322/caac.21150 CrossRef

38.

Johansen MA, Berntsen GR, Schuster T, Henriksen E, Horsch A (2012) Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlloed trials. Part 2: methodological quality and effects. J Med Internet Res 14:e126. https://doi.org/10.2196/jmir.2216 CrossRefPubMedPubMedCentral

39.

Kofoed S, Breen S, Gough K, Aranda S (2012) Benefits of remote real-time side-effect monitoring systems for patients receiving cancer treatment. Oncol Rev 6:e7. https://doi.org/10.4081/oncol.2012.e7 CrossRefPubMedPubMedCentral

40.

Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Roqak L, Bennett AV, Dueck AC, Atkinson TM, Chou JF, Dulko D, Sit L, Barz A, Novotny P, Fruscione M, Sloan JA, Schrag D (2016) Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol 34:557–565. https://doi.org/10.1200/JCO.2015.63.0830 CrossRefPubMed

41.

Kuijpers W, Groen WG, Aaronson NK, van Harten WH (2013) A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. J Med Internet Res 15:e37. https://doi.org/10.2196/jmir.2281 CrossRefPubMedPubMedCentral

42.

Leykin Y, Thekdi SM, Shumay DM, Munoz RB, Riba M, Dunn LB (2012) Internet interventions for improving psychological well-being in psycho-oncology: review and recommendations. Psychooncology 21:1016–1025. https://doi.org/10.1002/pon.1993 CrossRefPubMed

43.

Whittemore R (2005) Combining evidence in nursing research. Methods and implications. Nurs Res 54:56–62CrossRefPubMed

44.

Beatty L, Koczwara B, Wade T (2016) Evaluating the efficacy of a self-guided web-based CBT intervention for reducing cancer-distress: a randomized controlled trial. Support Care Cancer 24:1043–1051. https://doi.org/10.1007/s00520-015-2867-6 CrossRefPubMed

45.

Berry DL, Hong F, Halpenny B, Partridge AH, Fann JR, Wolpin S, Lober WB, Bush NE, Parvathaneni U, Back AL, Amtmann D, Ford R (2014) Electronic self-report assessment for cancer and self-care support: results of a multicenter randomized trial. J Clin Oncol 32:199–205. https://doi.org/10.1200/JCO.2013.48.6662 CrossRefPubMed

46.

Börösund E, Cvancarova M, Moore SM, Ekstedt M, Ruland CM (2014) Comparing effects in regular practice of e-communcation and web-based self-management support among breast cancer patients: preliminary results from a randomized controlled trial. J Med Internet Res 16:e295. https://doi.org/10.2196/jmir.3348 CrossRefPubMedPubMedCentral

47.

David N, Schlenker P, Prudlo U, Larbig W (2013) Internet-based program for coping with cancer: a randomized controlled trial with hematologic cancer patients. Psychooncology 22:1064–1072. https://doi.org/10.1002/pon.3104 CrossRefPubMed

48.

Donovan HS, Ward SE, Sereika SM, Knapp JE, Sherwood PR, Bender CM, Edwards RP, Fields M, Ingel R (2014) Web-based symptom management for women with recurrent ovarian cancer: a pilot randomized controlled trial of the WRITE symptoms intervention. J Pain Symptom Manag 47:218–230. https://doi.org/10.1016/j.jpainsymman CrossRef

49.

Duffecy J, Sanford S, Wagner L, Begale M, Nawacki E, Mohr DC (2013) Project onward: an innovative e-health intervention for cancer survivors. Psychooncology 22:947–951. https://doi.org/10.1002/pon.3075 CrossRefPubMed

50.

Gustafson DH, DuBenske LL, Namkoong K, Hawkins R, Chih MY, Atwood AK, Johnson R, Bhattacharva A, Carmack CL, Travnor AM, Campell TC, Buss MK, Govindan R, Schiller JH, Cleary JF (2013) An eHealth system supporting palliative care for patients with non-small cell lung cancer: a randomized trial. Cancer 119:1744–1751. https://doi.org/10.1002/cncr.27939 CrossRefPubMedPubMedCentral

51.

Kearney N, McCann L, Norrie J, Taylor L, Gray P, McGee-Lennon M, Sage M, Miller M, Maguire R (2009) Evaluation of a mobile phone-based, advanced symptom management system (ASyMS) in the management of chemotherapy-related toxicity. Support Care Cancer 17:437–444. https://doi.org/10.1007/s00520-008-0515-0 CrossRefPubMed

52.

Loiselle C, Edgar L, Batist G, Lu J, Lauzier S (2010) The impact of a multimedia informational intervention on psychosocial adjustment among individuals with newly diagnosed breast or prostate cancer. Patient Educ Couns 80:48–55. https://doi.org/10.1016/j.pec.2009.09.026 CrossRefPubMed

53.

Owen JE, Klapow JL, Roth DL, Shuster JL, Bellis J, Meredith R, Tucker DC (2005) Randomized pilot of a self-guided internet coping group for women with early stage breast cancer. Ann Behav Med 30:54–64CrossRefPubMed

54.

Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD (2012) Initial evaluation of an internet intervention to improve the sleep of cancer survivors with insomnia. Psychooncology 21:695–707. https://doi.org/10.1002/pon.1969 CrossRefPubMed

55.

Ruland CM, Andersen T, Jeneson A, Moore S, Grimsbö GH, Börösund E, Ellison MC (2013a) Effects of an internet support system to assist cancer patients in reducing symptom distress. A randomized controlled trial. Cancer Nurs 36:6–16. https://doi.org/10.1097/NCC.0b013e31824d90d4 CrossRefPubMed

56.

Ryhänen AM, Rankinen S, Siekkinen M, Saarinen M, Korvenranta H, Leino-Kilpi H (2013) The impact of an empowering Internet-Based Breast Cancer Patient Pathway Program on breast cancer patients’ clinical outcomes: a randomized controlled trial. J Clin Nurs 22:1016–1025. https://doi.org/10.1111/jocn.12007 CrossRefPubMed

57.

Schover LR, Canada AL, Yuan Y, Sui D, Neese L, Jenkins R, Rhodes MM (2012) A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer 118:500–509. https://doi.org/10.1002/cncr.26308 CrossRefPubMed

58.

van den Berg SW, Gielissen MF, Custers JA, van der Graaf WT, Ottevanger PB, Prins JB (2015) BREATH: web-based self-management for psychological adjustment after primary breast cancer—results of a multicenter randomized controlled trial. J Clin Oncol 33:2763–2771. https://doi.org/10.1200/JCO.2013.54.9386 CrossRefPubMed

59.

van den Brink JL, Moorman PW, de Boer MF, Hop WC, Pruyn JF, Verwoerd CD, van Bemmel JH (2007) Impact on quality of life of a telemedicine system supporting head and neck cancer patients: a controlled trial during the postoperative period at home. J Am Med Inform Assoc 14:198–205CrossRefPubMedPubMedCentral

60.

Yun YH, Lee KS, Kim YW, Park SY, Lee ES, Noh DY, Kim S, Oh JH, Jung SY, Chung KW, Lee YJ, Jeong SY, Park KJ, Shim YM, Zo JI, Park JW, Kim YA, Shon EJ, Park S (2012) Web-based tailored education program for disease-free cancer survivors with cancer-related fatigue: a randomized controlled trial. J Clin Oncol 30:1296–1303. https://doi.org/10.1200/JCO.2011.37.2979 CrossRefPubMed

61.

Wheelock AE, Bock MA, Martin EL, Hwang J, Ernest ML, Rugo HS, Esserman LJ, Melisko ME (2015) SIS.NET: a randomized controlled trial evaluating a web-based system for symptom management of breast cancer. Cancer 121:893–899. https://doi.org/10.1002/cncr.29088 CrossRefPubMed

62.

Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB (2003) Evaluation of an internet support group for women with primary breast cancer. Cancer 97:1164–1172CrossRefPubMed

63.

Wootten AC, Abbott JA, Meyer D, Chisholm K, Austin DW, Klein B, McCabe M, Murphy DG, Costello AJ (2015) Preliminary results of a randomized controlled trial of an online psychological intervention to reduce distress in men treated for localized prostate cancer. Eur Uro 68:471–479. https://doi.org/10.1016/j.eururo.2014.10.024 CrossRef

64.

Ruland CM, Maffei R, Börösund E, Krahn A, Andersen T, Grimsbö GH (2013b) Evaluation of different features of an eHealth application for personalized illness managment support: cancer patients’ use and appraisal of usefulness. Int J Med Infor 82:593–603. https://doi.org/10.1016/j.ijmedinf.2013.02.007 CrossRef

65.

National Cancer Coalition Network (2016). Distress management guidelines Available at: https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf

Title: Effects of web-based interventions on cancer patients’ symptoms: review of randomized trials
Authors: N. Fridriksdottir
S. Gunnarsdottir
S. Zoëga
B. Ingadottir
E. J. G. Hafsteinsdottir
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 2/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3882-6

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Geriatric assessment with management intervention in older adults with cancer: a randomized pilot study

Madarosis: a qualitative study to assess perceptions and experience of Australian patients with early breast cancer treated with taxane-based chemotherapy

Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data

How to report adherence to treatment as clinically relevant data—making a case of CML and TKI

Effects of acupuncture on cancer-related fatigue: a meta-analysis

The gut microbiome, symptoms, and targeted interventions in children with cancer: a systematic review

Keynote webinar | Spotlight on antibody–drug conjugates in cancer