Effectiveness of e‐health based self‐management to improve cancer‐related fatigue, self‐efficacy and quality of life in cancer patients: systematic review and meta‐analysis

AIMS: To integrate the overall effect of e-health based self-management on cancer-related fatigue (CRF), self-efficacy, and quality of life (QOL) among adult cancer patients. DESIGN: A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: We researched PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Web of Science and Embase up to 14 July 2019. REVIEW METHODS: We conducted the review with the Cochrane Handbook (version 5.1.0) and measured the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS: Literature searching identified 15 trials with a total of 2,337 participants. Integrated results analysis of e-health based self-management demonstrated a statistically significant but small effect on CRF and self-efficacy, but no statistically significant improvement on the QOL. Meanwhile, subgroup analysis indicated that e-health based self-management had a larger effect on fatigue compared with usual care/waiting list control. CONCLUSION: E-health based self-management is effective for CRF and self-efficacy, but not the QOL. More high-quality randomized control trials are warranted to confirm these conclusions. IMPACT: Results showed e-health could improve fatigue and self-efficacy but not the QOL. Health providers could take into the various factors of e-health interventions when providing telehealth service. Other researchers might be inspired by the current review before they begin a study about e-health.