Using eHealth to support quality of life and wellbeing in lung cancer patients: a systematic review. (Preprint)
Authors: Harrison Virginia , Jones Katie , Hyde Caroline 
Published: December 2024

BACKGROUND

Lung cancer, the leading cause of cancer-related deaths globally, profoundly impacts patients' quality of life (QoL) and psychological wellbeing due to the physical, emotional, and social challenges associated with the disease and its treatment. Addressing these needs is critical, yet many patients experience unmet psychological and QoL support needs. eHealth, the use of information and communication technology to support health, offers a scalable solution to provide timely and tailored support to lung cancer patients.

OBJECTIVE

This review aimed to evaluate the impact of eHealth interventions on QoL and psychological wellbeing in lung cancer patients by identifying the different approaches used, exploring their acceptability and engagement, and characterising the most effective strategies.

METHODS

A systematic review was conducted following PRISMA guidelines. Literature searches across six databases were performed to identify experimental and quantitative studies that assessed eHealth interventions targeting QoL and/or psychological wellbeing in lung cancer patients. Data extraction focused on study characteristics, intervention details, outcomes, engagement and acceptability metrics. Study quality was assessed using a modified version of the Downs and Black checklist, and a synthesis without meta-analysis (SWiM) was conducted due to study heterogeneity.

RESULTS

7,065 records were screened and a total of 33 studies were included. The identified eHealth interventions ranged from digital symptom monitoring, patient education, virtual psychological support, physical activity interventions, nurse-led interventions, and multi-component portals/programs. Multi-component eHealth strategies demonstrated the greatest impact on both QoL and psychological wellbeing. In addition, mindfulness-based interventions reduced anxiety and depression, and physical activity programs improved QoL. Patient engagement varied across studies although user acceptability was generally high; with personalisation identified as a key factor for positive outcomes, alongside intervention length and clinician input. However, many studies were pilot or feasibility studies with small sample sizes, limiting the generalisability of findings.

CONCLUSIONS

eHealth interventions show promise in improving QoL and psychological wellbeing for lung cancer patients, particularly multi-component programs addressing diverse patient needs. Thus, scalable eHealth solutions have the potential to address significant gaps in lung cancer care and improve patient outcomes. However, substantial heterogeneity and methodological limitations highlight the need for more robust, large-scale studies. Future research should prioritise optimising patient engagement and adherence to maximise the efficacy of these interventions.

CLINICALTRIAL

PROSPERO (International Prospective Register of Systematic Reviews) CRD42024509607; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024509607