Effectiveness of Psychosocial care interventions in improving the Quality of Life for Adult Patients with Cancer in low-and middle-income countries (LMICs): A Systematic Review and Meta-Analysis
Authors: Kavuma David , Obuku Ekwaro Anthony , Namisango Eve , Kansiime Rachel , Niyonzima Nixon , Kinengyere Alison Annet , Kasasa Simon , Makumbi Fredrick Edward , Kafeero Hussein Mukasa , Nuwaha Fred 
Published: December 2024

Abstract

Introduction
Psychosocial care improves the quality of life (QoL) for cancer patients and their families. A growing body of randomized controlled trials (RCTs) and quasi experimental studies have been published and systematic reviews have been done on psychosocial interventions in cancer care in the recent past, in the low-and-middle income countries (LMICs). However, a quantitative assessment of the effectiveness of psychosocial interventions in cancer care for adults living with cancer in LMICs is missing. This study aimed at synthesizing the available evidence on the effectiveness of psychosocial care interventions towards the improvement of the quality of life of adult patients with cancer in LMICs.
Methods
We registered the protocol of this study with PROSPERO (ID: CRD4202342156) before conducting this systematic review and meta-analysis of original studies on psychosocial care interventions in cancer care for adults with cancer in LMICs. Studies published between 1st January 2002 and 31st December 2023 in any LMIC, were searched from various electronic databases which included Ovid MEDLINE (PubMed), Web of Science, EmBASE, APA PsycINFO, and Google Scholar. We followed the standard guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) standards.
Results
Twenty-six RCTs and quasi experimental studies (with 3,878 participants, 1,955 in study arm and 1,923 in control arm) were included in this systematic review and meta-analysis. Sixty-nine percent (n=18) of the included studies were RCTs. The study sizes ranged between 24 and 2140 participants. Most of the included studies (46%) were published between 2016 and 2019. Of the five WHO regions, the Eastern Mediterranean region had the highest number (62%, 18) of the included studies and Africa region has only three studies (1 from Ethiopia and 2 from Nigeria) in this meta-analysis.
The biggest number of psychosocial care interventions utilised by the included studies belonged to the Cognitive Behavioural therapy (CBT) (38%, n=10 studies) followed by Mindfulness-based therapy (MBT) with 31% (n=8) with Family systems therapy trailing with 4% (n=1). From the subgroup analyses of the means and standard deviations of domains of quality of life in the pooled primary studies, the respective standardized mean differences (SMD) indicated that the psychosocial care intervention had a significant positive effect on the physical (0.972: p= 0.002), social (0.884: p=0.005) and psychological (0.590: p= 0.03) domains of quality of life of adult patients with cancer. However, the negative SMD for depression (-1.612: p=0.007) and anxiety (-3.313: p= <0.001) domains indicates that the psychosocial care interventions in the primary studies for these domains did not improve the quality of life of study participants. The CBT-related psychosocial care interventions significantly improved in the QoL of adult patients with cancer compared to the interventions that belonged to other models.
Conclusion
On the overall, psychosocial care interventions effectively improved most domains of the QoL of adult patients with cancer. Future research is needed for those interventions whose findings had negative effect on some domains of the QoL of patients with cancer.