Effect of mHealth interventions on psychological issues experienced by women diagnosed with breast cancer receiving chemotherapy: A systematic review and meta-analysis

Background: A range of psychological issues often accompany breast cancer chemotherapy. Owing to their ubiquity, mobile phones have been used to deliver supportive interventions that address these issues. However, we currently lack sufficient evidence to guide the design of such interventions. Aim: To analyse and synthesise available evidence on the effectiveness of mobile-phone-based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. Methods: A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta-analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. Results: The review included ten published studies which covered 1,548 patients. The meta-analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p = .01, I 2 = 17%). No significant effects were found for anxiety (SMD = -0.01, 95% CI [-0.26, 0.25], p = 0.96, I 2 = 53%) and depression (SMD = 0.02, 95% CI [-0.17, 0.20], p = .87, I 2 = 0%). Individual studies suggest reduced symptom prevalence ( p = .033, d =.27), symptom distress ( p = .004, d = .004), symptom interference ( p = .02, d = . 51),supportive care needs ( p < .05, d = 2.43); improved self-efficacy ( p = .03, d = 0.53), self-esteem ( p <.001, d = 0.87) andemotional functioning ( p = .008, d = .30). The methodological quality ranged from low to moderate. Conclusion: mHealth interventions might be helpful in addressing certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are hereby warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies