Effect of Telehealth Intervention on Quality of Life of Cancer Patients: A Narrative Review

Introduction

Cancer is known as one of the predominant health issues in the world. In 2012, 14.1 million new cancer patients, 8.2 million deaths, and 32.6 million cancer survivors were reported. In Australia onethird of the total population develop cancer before they get 75 years old [1]. Also, it is estimated that 30.2 million people will be living with cancer which is 1.5 times higher than in 2020 Thanks to technology, there has been a vast majority of treatments such as chemotherapy, radiation, and surgery for this disease, however, there are some adverse effects following these treatments that can reduce both survival time and quality of life [2-4]. As these treatments become more severe the adverse effects that patients may experience result in harming functional capacity and poor quality of life [5]. Moreover, the nature of cancer diagnosis can cause many physical and psychological health issues like fatigue, physical pain, the strain on interpersonal relationships, anxiety, and depression for patients. Anxiety and Depression account for 10% to 20% of the cancer population and can have a negative impact on their lives [6,7]. Since cancer is becoming more prevalent worldwide and with increasing morbidity each year, quality of life plays a key role in the long-term impact of cancer and treatment [8]. Studies reported that the quality of life cancer patients during treatment reduced in 3 months which was followed by slow recovery [9]. Also, a study indicated that potential treatment side effects on women who have been diagnosed by breast cancer can significantly decrease their quality of life [10]. To achieve a better quality of life, a clear understanding of long-term survivorship and the effect of quality of life is needed [11]. Therefore, there is a great demand to support cancer patients physiologically and socially over the past decade [7].

As mentioned earlier, cancer populations suffer from various physiological distress which can be interfered by coping strategies. Thus, a proper management can lead to better coping skills, reduced distress and improvement in quality of life [12]. There have been many interventions related to cancer patients’ quality of life, however, telehealth interventions are limited to some certain chronic diseases and there are few interventions related to cancer patients. However, studies show that telehealth in different forms such as images, videos, text messages can effectively reduce the length of hospitalisation, referring to the hospital for emergency care, financial expenses and enhance the management of disease in critical conditions. It is worth noting that the patients report a high level of satisfaction using telehealth [13]. Another study showed that e-health application provided them insight, information related to their disease, and they were able to access to supportive care as well [14]. The impact of telehealth interventions highlighted once Covid-19 appeared and many cancer patients were susceptible to coronavirus infection, particularly those who were under chemotherapy treatment and their treatment would delay if they get infected seriously [15]. Telehealth is mainly used at home. It can be interactive with nurses, doctors and peers or noninteractive [16]. This paper aims to assess the effect of Telehealth Intervention on cancer patients’ quality of life.

Methodology

Data Resources and Research Strategies

The data has been collected from MEDLINE, Science direct, Embase, CINAHL, SCOPUS, Cochrane Library, Scopus and Web of Science. The research terms were as follows: Cancer patients, Cancer AND Quality of life, Cancer patients AND Quality of life, Cancer patient AND Telehealth, Cancer patients AND Interventions, Cancer AND Telehealth, Quality of life, Quality of life AND Telehealth, Quality of life AND Telehealth Interventions, Cancer AND Mobile app, Cancer Patients AND E-Health, Cancer AND Cell phone, Quality of life OR Cancer, Quality of life OR Cancer patients, Quality of life OR Telehealth, Quality of life OR Telehealth Intervention, Cancer OR quality of life, Cancer patients OR Quality of life, Cancer OR Telehealth, Cancer OR Telehealth Intervention. The study was based on adult subjects and randomized clinical trial, systematic review, meta-analysis and narrative review were included. The papers were reviewed from 2010 to 2023.

Inclusion and Exclusion Criteria/

A researcher screened and searched for papers according to following eligibility:
i. Participants should be between 18 and 60,
ii. Cancer diagnosis,
iii. Randomized clinical trial should be performed on cancer patients at any stage,
iv. The intervention should be based on e-health and Telehealth,
v. Systematic, meta-analysis review should assess randomized clinical trial with comparison (before and after),
vi. The quality of life should be one of elements which was assessed in the studies,
vii. The papers’ language in English and Farsi.

Findings

Table 1:Study process chart.

The total number of 978 articles were searched on databases. According to criteria 915 articles were excluded and 63 article assessed by the Team Review, 40 articles were excluded after discussion and at the end 23 articles were selected for data analysis. Table 1 shows the process followed in this study to perform the review.

Conclusion

The data shows that some cancer patients can benefit from Telehealth programs an alleviate the side effects and improve quality of life. The interventions like internet-based exercise had a positive effect on quality-of-life breast cancer patients [17,18]. Female cancer patients with different diagnosis also reported that they experienced less fatigue and a better sleep quality after participating in the e-health intervention [19]. Another Systematic review reported potential benefits to improve pain, depression and quality of life, however, more resources are needed to assess the impact of Telehealth interventions [20]. However, there are some population who need to be assisted in device operation which should be considered for the future studies [21]. Also, the care can be delivered to the patients equally [22]. Therefore, it can be concluded that cancer patients may benefit from Telehealth programs while there are some barries which required to be clarified in future studies.

References

• Brunelli VN, Fox JA, Langbecker DH (2021) Disparity in cancer survivorship care: A cross-sectional study of telehealth use among cancer nurses in Australia. Collegian 28(5): 498-505.
• Cheng X, Wei S, Zhang H, Xue S, Wang W, et al. (2018) Nurse-led interventions on quality of life for patients with cancer: A meta-analysis. Medicine (Baltimore) 97(34): e12037.
• Xunlin NG, Lau Y, Klainin-Yobas P (2020) The effectiveness of mindfulness-based interventions among cancer patients and survivors: a systematic review and meta-analysis. Support Care Cancer 28(4): 1563-1578.
• Li Y, Li J, Zhang Y, Ding Y, Hu X (2022) The effectiveness of e-Health interventions on caregiver burden, depression, and quality of life in informal caregivers of patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 127: 104179.
• Samuel SR, Maiya AG, Fernandes D J, Guddattu V, Saxena PUP, et al. (2019) Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy. Support Care Cancer 27(10): 3913-3920.
• Bosman JT, Bood ZM, Scherer-Rath M, Dörr H, Christophe N, et al. (2021) The effects of art therapy on anxiety, depression, and quality of life in adults with cancer: a systematic literature review. Support Care Cancer 29(5): 2289-2298.
• Lang-Rollin I, Berberich G (2018) Psycho-oncology. Dialogues Clin Neurosci 20(1): 13-22.
• Firkins J, Hansen L, Driessnack M, Dieckmann N (2020) Quality of life in "chronic" cancer survivors: a meta-analysis. J Cancer Surviv 14(4): 504-517.
• da Silva HEC, Santos GNM, Ferreira Leite A, Mesquita CRM, de Souza Figueiredo PT, et al. (2022) The feasibility of telehealth in the monitoring of head and neck cancer patients: a systematic review on remote technology, user adherence, user satisfaction, and quality of life. Supportive Care in Cancer 30(10): 8391-8404.
• Hou IC, Lin HY, Shen SH, Chang KJ, Tai HC, et al. (2020) Quality of Life of Women After a First Diagnosis of Breast Cancer Using a Self-Management Support mHealth App in Taiwan: Randomized Controlled Trial. JMIR Mhealth Uhealth 8(3): e17084.
• Harley C, Pini S, Bartlett YK, Velikova G (2012) Defining chronic cancer: patient experiences and self-management needs. BMJ Support Palliat Care 2(3): 248.
• Gitonga I, Desmond D, Duda N, Maguire R (2022) Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta-analysis. Psychooncology 31(10): 1621-1636.
• Li J, Liu Y, Jiang J, Peng X, Hu X (2021) Effect of telehealth interventions on quality of life in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 122: 103970.
• Lubberding S, van Uden-Kraan CF, Te Velde EA, Cuijpers P, Leemans CR et al. (2015) Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors. J Clin Nurs 24(9-10): 1367-1379.
• Toohey K, Paterson C, Moore M, Hunter M (2022) Towards best practice in the delivery of prescribed exercise via telehealth for individuals diagnosed with cancer: A randomised controlled trial protocol. Contemporary Clinical Trials 119: 106833.
• Busey JC, Michael P (2008) Telehealth--opportunities and pitfalls. J Am Diet Assoc 108(8): 1296-1301.
• Galiano-Castillo N, Cantarero-Villanueva I, Fernández-Lao C, Ariza-García A, Díaz-Rodríguez L, et al. (2016) Telehealth system: A randomized controlled trial evaluating the impact of an internet-based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors. Cancer 122(20): 3166-3174.
• Larson J L, Rosen AB, Wilson FA (2020) The effect of telehealth interventions on quality of life of cancer survivors: A systematic review and meta-analysis. Health Informatics J 26(2): 1060-1078.
• Seib C, Anderson D, McGuire A, Porter-Steele J, McDonald N, et al. (2022) Improving health-related quality of life in women with breast, blood, and gynaecological Cancer with an eHealth-enabled 12-week lifestyle intervention: the women's wellness after Cancer program randomised controlled trial. BMC Cancer, 22(1): 747.
• Agboola SO, Ju W, Elfiky A, Kvedar JC, 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. J Med Internet Res 17(3): e65.
• Adames A, Briody P, Brown S, Ford J, Tolda C, et al. (2023) The impact of telehealth on nursing care in the radiation oncology setting during the COVID-19 pandemic. Asia Pac J Oncol Nurs 10(2): 100182.
• Bu S, Smith AB, Janssen A, Donnelly C, Dadich A, et al. (2022) Optimising implementation of telehealth in oncology: A systematic review examining barriers and enablers using the RE-AIM planning and evaluation framework. Crit Rev Oncol Hematol 180: 103869.