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The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review

  • Elizabeth Hernandez SilvaEmail author
  • Sheleigh Lawler
  • Danette Langbecker
Review

Abstract

Purpose

Integrating mHealth into the cancer care continuum may be an effective strategy to improve cancer survivorship care by supporting self-management. We aim to assess the effectiveness of mHealth applications (apps) for self-management in improving pain, psychological distress, fatigue, or sleep outcomes in adult cancer survivors.

Methods

Experimental quantitative studies evaluating apps aiming to support self-management for adult cancer survivors and reporting pain, psychological distress, fatigue, or sleep outcomes were included. PubMed, Web of Science, Embase, CINAHL, PsycINFO, Scopus, and CENTRAL databases were searched from inception through December 2017. Risk of bias was assessed using the Cochrane risk of bias tool (PROSPERO registration number CRD42017081182).

Results

Seven studies of six mHealth interventions (n = 949 participants) were included. Two randomized controlled trials (RCTs), one quasi-RCT, one non-RCT, and three single-arm studies involved survivors with a mix of cancer types. The most common app features were symptom questionnaires (n = 5) and progress tracking (n = 5). Four studies reported outcomes for pain, with three showing improvements. Two studies reported psychological distress outcomes, showing mixed results. Four studies reported improvements in fatigue post-intervention or in the intervention compared with control group, but the changes were not all statistically significant. Two studies reported improvements in sleep outcomes.

Conclusions

There is emerging evidence that mHealth interventions that support self-management can improve pain and fatigue outcomes in cancer survivors, and some promise for psychological distress and sleep outcomes. Further development and investigation of mHealth is needed, incorporating targeted, evidence-based models of care into app design.

Implications for Cancer Survivors

mHealth interventions can improve outcomes for cancer survivors and have significant potential to benefit this growing population due to their reach.

Keywords

mHealth Mobile applications Neoplasms Survivorship Self-management 

Notes

Compliance with ethical standards

This article does not contain any studies with human participants or animals performed by the authors.

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

11764_2018_730_MOESM1_ESM.docx (34 kb)
ESM 1 (DOCX 33 kb)

References

  1. 1.
    Statista. Number of smartphone users worldwide from 2014 to 2020. 2018. https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide/.
  2. 2.
    Mendiola M, Kalnicki M, Lindenauer S. Valuable features in mobile health apps for patients and consumers: content analysis of apps and user ratings. JMIR mHealth uHealth. 2015;3(2):e40.  https://doi.org/10.2196/mhealth.4283. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Anderson K, Burford O, Emmerton L. Mobile health apps to facilitate self-care: a qualitative study of user experiences. Report. 2016;11(5):e0156164.  https://doi.org/10.1371/journal.pone.0156164.CrossRefGoogle Scholar
  4. 4.
    Birkhoff SD, Smeltzer SC. Perceptions of smartphone user-centered mobile health tracking apps across various chronic illness populations: an integrative review. J Nurs Scholarsh. 2017;49(4):371–8.  https://doi.org/10.1111/jnu.12298.CrossRefPubMedGoogle Scholar
  5. 5.
    Davis SW, Oakley-Girvan I. Achieving value in mobile health applications for cancer survivors. J Cancer Surviv. 2017;11(4):498–504.  https://doi.org/10.1007/s11764-017-0608-1.CrossRefPubMedGoogle Scholar
  6. 6.
    Darlow S, Wen KY. Development testing of mobile health interventions for cancer patient self-management: a review. Health Informatics Journal. 2016;22(3):633–50.  https://doi.org/10.1177/1460458215577994.CrossRefPubMedGoogle Scholar
  7. 7.
    Bender JL, Yue RYK, To MJ, Deacken L, Jadad AR. A lot of action, but not in the right direction: systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. J Med Internet Res. 2013;15(12).  https://doi.org/10.2196/jmir.2661.
  8. 8.
    Aaronson NK, Mattioli V, Minton O, Weis J, Johansen C, Dalton SO, et al. Beyond treatment - psychosocial and behavioural issues in cancer survivorship research and practice. EJC Suppl. 2014;12(1):54–64.  https://doi.org/10.1016/j.ejcsup.2014.03.005.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Pachman DR, Barton DL, Swetz KM, Loprinzi CL. Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30(30):3687–96.  https://doi.org/10.1200/JCO.2012.41.7238. CrossRefGoogle Scholar
  10. 10.
    Prue G, Rankin J, Allen J, Gracey J, Cramp F. Cancer-related fatigue: a critical appraisal. Eur J Cancer. 2006;42(7):846–63.  https://doi.org/10.1016/j.ejca.2005.11.026.CrossRefPubMedGoogle Scholar
  11. 11.
    Mao JJ, Armstrong K, Bowman MA, Xie SX, Kadakia R, Farrar JT. Symptom burden among cancer survivors: impact of age and comorbidity. Journal of the American Board of Family Medicine : JABFM. 2007;20(5):434–43.  https://doi.org/10.3122/jabfm.2007.05.060225.CrossRefPubMedGoogle Scholar
  12. 12.
    Brebach R, Sharpe L, Costa DSJ, Rhodes P, Butow P. Psychological intervention targeting distress for cancer patients: a meta-analytic study investigating uptake and adherence. Psychooncology. 2016;25:882–90.  https://doi.org/10.1002/pon.4099.CrossRefPubMedGoogle Scholar
  13. 13.
    Boland L, Bennett K, Connolly D. Self-management interventions for cancer survivors: a systematic review. Support Care Cancer. 2018;26(5):1585–95.  https://doi.org/10.1007/s00520-017-3999-7. CrossRefPubMedGoogle Scholar
  14. 14.
    Carroll J, Moorhead A, Bond R, Leblanc W, Petrella R, Fiscella K. Who uses mobile phone health apps and does use matter? A secondary data analytics approach. J Med Internet Res. 2017;19(4):E125.  https://doi.org/10.2196/jmir.5604.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.  https://doi.org/10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Adams KM, Corrigan J. Priority areas for national action : transforming health care quality. Washington, D.C.: National Academies Press; 2003.Google Scholar
  17. 17.
    The Cochrane Collaboration. Assessing risk of bias in included studies. In: Higgins JPT AD, Sterne JAC, editor. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Online: The Cochrane Collaboration; 2011.Google Scholar
  18. 18.
    Kearney N, McCann L, Norrie J, Taylor L, Gray P, McGee-Lennon M, et al. Evaluation of a mobile phone-based, advanced symptom management system (ASyMS) in the management of chemotherapy-related toxicity. Support Care Cancer. 2009;17(4):437–44.  https://doi.org/10.1007/s00520-008-0515-0.CrossRefPubMedGoogle Scholar
  19. 19.
    Mayer DK, Landucci G, Awoyinka L, Atwood AK, Carmack CL, Demark-Wahnefried W, et al. SurvivorCHESS to increase physical activity in colon cancer survivors: can we get them moving? J Cancer Surviv. 2017;12:1–13.  https://doi.org/10.1007/s11764-017-0647-7. CrossRefGoogle Scholar
  20. 20.
    Uhm KE, Yoo JS, Chung SH, Lee JD, Lee I, Kim JI, et al. Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res Treat. 2017;161(3):443–52.  https://doi.org/10.1007/s10549-016-4065-8.CrossRefPubMedGoogle Scholar
  21. 21.
    Sundberg K, Wengstrom Y, Blomberg K, Halleberg-Nyman M, Frank C, Langius-Eklof A. Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer. Support Care Cancer. 2017;25:2195–204.  https://doi.org/10.1007/s00520-017-3625-8.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Smith SK, Kuhn E, O'Donnell J, Koontz BF, Nelson N, Molloy K, et al. Cancer distress coach: pilot study of a mobile app for managing posttraumatic stress. Psychooncology. 2016.  https://doi.org/10.1002/pon.4363.
  23. 23.
    Fu MR, Axelrod D, Guth AA, Rampertaap K, El-Shammaa N, Hiotis K, et al. mHealth self-care interventions: managing symptoms following breast cancer treatment. Mhealth. 2016;2:28.  https://doi.org/10.21037/mhealth.2016.07.03.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Maguire R, Ream E, Richardson A, Connaghan J, Johnston B, Kotronoulas G, et al. Development of a novel remote patient monitoring system: the advanced symptom management system for radiotherapy to improve the symptom experience of patients with lung cancer receiving radiotherapy. Cancer Nurs. 2015;38(2):E37–47.  https://doi.org/10.1097/NCC.0000000000000150.CrossRefPubMedGoogle Scholar
  25. 25.
    Kessels E, Husson O, Van Der Feltz-Cornelis CM. The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Neuropsychiatr Dis Treat. 2018;Volume 14:479–94.CrossRefGoogle Scholar
  26. 26.
    Langendijk JA, Aaronson NK, de Jong JM, ten Velde GP, Muller MJ, Lamers RJ, et al. Prospective study on quality of life before and after radical radiotherapy in non-small-cell lung cancer. J Clin Oncol. 2001;19(8):2123–33.  https://doi.org/10.1200/JCO.2001.19.8.2123.CrossRefPubMedGoogle Scholar
  27. 27.
    Gilbert B, Goodman E, Chadda A, Hatfield D, Forman D, Panch T. The role of mobile health in elderly populations. Current Geriatrics Reports. 2015;4(4):347–52.  https://doi.org/10.1007/s13670-015-0145-6.CrossRefGoogle Scholar
  28. 28.
    Abelson JS, Symer M, Peters A, Charlson M, Yeo H. Mobile health apps and recovery after surgery: what are patients willing to do? Am J Surg. 2017;214(4):616–22.  https://doi.org/10.1016/j.amjsurg.2017.06.009.CrossRefPubMedGoogle Scholar
  29. 29.
    Parry C, Kent EE, Mariotto AB, Alfano CM, Rowland JH. Cancer survivors: a booming population. Cancer Epidemiol Biomark Prev. 2011;20(10):1996.  https://doi.org/10.1158/1055-9965.EPI-11-0729.CrossRefGoogle Scholar
  30. 30.
    Rho M, Kim H, Chung K, Choi I. Factors influencing the acceptance of telemedicine for diabetes management. The Journal of Networks, Software Tools and Applications. 2015;18(1):321–31.  https://doi.org/10.1007/s10586-014-0356-1.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Online Health/Centre for Health Services ResearchThe University of QueenslandWoolloongabbaAustralia
  2. 2.Cancer Prevention Research Centre, School of Public HealthThe University of QueenslandHerstonAustralia

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