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