Table 3.
Summary of results of the included studies.
| Author (Year) | Outcome Measures | Results | Other Effects | |||
|---|---|---|---|---|---|---|
| Pre | Post | Assessment | ||||
| T1 | T2 | |||||
| McCarthy et al. (2018) [20] | BL | 6 weeks | • CSD (TST, SE, SOL, WASO, NA) • ISI • DBAS-16 • EORTC QLQ-C30 • R-PFS • HADS • MRS |
• Significant improvements in sleep outcomes, including SE, SOL, WASO, TST, and NA (p < 0.001), QOL and daily functioning • Significant decreases in ISI and DBAS (p < 0.001) • Significant improvements in QOL (p < 0.001) and significant decrease in fatigue (p = 0.000) • No significant changes in anxiety (p = 0.417) or depression (p = 0.16) • Significant decrease in total menopausal symptoms (p < 0.001) |
||
| Skolarus et al. (2019) [21] | BL | 5 months | 12 months | • EPIC •Confidence in self-management • Cancer control and outlook • PEPPI • Coping appraisal |
• Significantly higher in all EPIC domain areas in the intervention group from baseline at 5 and 12 months (p < 0.001) but no significant differences between groups maintained at 12 months • Improvement in symptom focus area domains in the intervention group from baseline at 5 and 12 months • No differences in confidence in symptom self-management, cancer control and outlook, or PEPPI at 5 months • higher coping appraisal in the intervention group at 5 months (p = 0.02) |
• Satisfaction rate with the program and intention to recommend: 80% or more |
| Kim et al. (2011) [22] | BL | 3 months | •Stage of motivational readiness for exercise and diet • IPAQ • DQI • EORTC QLQ-C30 • HADS • BFI |
• Significantly greater improvement in motivational readiness for exercise and diet, emotional functioning, fatigue, and depression in the intervention group • Significantly worsened DQI in the intervention group compared to that in the control group (p = 0.005) |
• Adherence rate in IG: 94% for exercise, 91% for diet • Helpfulness rate in IG: 95% • Appropriateness of contents in IG: 96% for duration, 91% for frequency |
|
| Galiano-Castillo et al. (2016) [23] | BL | 2 months | 6 months | • EORTC QLQ-C30 • BPI • Isometric handgrip strength • Isometric abdominal strength • Isometric back strength • Lower body strength • R-PFS |
• Significantly improved global health status, physical, role, cognitive functioning, and arm symptoms scores (all, p < 0.01) as well as pain severity (p = 0.001) and pain interference (p = 0.045) in the telerehabilitation group compared to the control group at 2 months • Significant improvements in affected and nonaffected side handgrip (both, p = 0.006); abdominal, back, and lower body strength (all, p < 0.01), and total fatigue (p < 0.001) in the telerehabilitation group at 2 months • These findings were maintained after 6-months of follow-up |
• Adherence rate: 93.9% • Satisfaction rate in TH group: 97.8% |
| Meneses et al. (2018) [24] | BL | 3 months | 6 months | • SF-36 • CES-D |
• Similar scores in physical and emotional well-being over time • Improved pain levels over 6 months (high effect size) • Improved fatigue scores at 3 months (moderate effect size) • Elevated depressive symptoms but no clinically significant change |
|
| Frensham et al. (2018) [25] | BL | 3 months | 6 months | •Physical Activity using pedometer • Anthropometry (standing stretch stature, body weight, waist and hip girths) • Physiological measures (blood pressure) • 6MWT • SF-36 |
• Significant improvements in physical fitness (p < 0.01), systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.01), waist girth (p < 0.01), mental health (p < 0.05), social functioning (p < 0.01), and general health (p < 0.01) but an increase in bodily pain (p < 0.01) from baseline to 3 and 6 months | |
| Willems et al. (2017) [26] | BL | 6 months | • EORTC QLQ-C30 • HADS • CIS |
• Significant effect on increasing emotional (p = 0.022,) and social functioning (p = 0.011) and decreasing depression (p = 0.007) and fatigue (p = 0.020) in the intervention group but less strong evidence | • Average use of module: 2.22 ± 1.58 • Average time between first login and last use of a module: 10.67 ± 6.78 weeks • Adherence rate: 83.9% |
|
| Freeman et al. (2015) [27] | BL | 1 months | 3 months | • SF-36 • FACT-B • FACIT-F • FACT-Cog • FACIT-Sp-Ex • BSI-GSI • PSQI |
• Significant improvement in fatigue, cognitive dysfunction, sleep disturbance, and health-related and breast cancer-related QOL in LD and TD compared to WL at 3 months (p < 0.01) • No differences between LD and TD at 3 months |
|
| Zachariae et al. (2018) [28] | BL | 9 weeks | 15 weeks | • ISI • FACIT-F • Sleep diary (SOL, NA, WASO, EMA, TIB, TST, SE, sleep aids) |
• Statistically significant improvement in all sleep-related outcomes from pre- to postintervention (p < 0.02) • Effect sizes (Cohen’s d) ranged from 0.33 (95% CI = 0.06 to 0.61) for wake after sleep onset to 1.17 (95% CI = 0.87 to 1.47) for insomnia severity • Maintained improvements for outcomes measured at follow-up (d = 0.66–1.10) |
• Number of cores completed in TH group: 4.1 ± 2.5/6 • No differences between groups in the mean number of completed sleep diaries at baseline or postintervention |
| Kanera et al. (2017) [29] | BL | 6 months | 12 months | • SQUASH • Vegetable consumption (number of days per week, number of vegetable servings per day) |
• Significant effect after 12 months for moderate physical activity (complete cases: p = 0.010; intention-to-treat: p = 0.011) in the intervention group • No significant intervention effect after 12 months for vegetable consumption (complete cases: p = 0.121; intention-to-treat: p = 0.132) in the intervention group |
• Intervention effect among participants aged younger than 57 years (p = 0.000) |
| Galiano-Castillo et al. (2017) [30] | BL | 8 weeks | 6 months | • 6MWT • ACT • TMT |
• Significantly improved distances (p < 0.001) and percentages of predicted 6 min walk test (p < 0.001) in the intervention group compared to the control; findings maintained after 6 months (p = 0.001; p = 0.002) • Significant improvement in the number of consonants recalled in the intervention group compared to that in the control group (p = 0.04); finding maintained after 6 months (p = 0.02) |
|
| Syrjala et al. (2018) [31] | BL | 6 months | • CTXD • SCL-90-R • SF-36 • FSI |
• No differences in the mean change in aggregated outcomes in distress, depression, fatigue, and physical function among three groups (p = 0.30) • Analyses of participants with impaired scores showed significantly improved distress for INSPIRE + PST compared to controls (p = 0.032) • A trend toward improvement in distress in the INSPIRE alone group (p = 0.075), no differences between intervention arms and controls in rates of change in depressive symptoms, fatigue, or physical functioning (RR 0.6 to 1.4) • Marginal benefit in distress with the addition of TH PST, particularly for those who viewed the website or were age 40 years or older |
||
| Lozano- Lozano et al. (2019) [33] | BL | 2 months | • EORTC QLQ-C30 • SEPA • PA using accelerometry • Anthropometrics (BMI, percentage of fat mass, bone mineral density, height, weight) |
• Significant improvements in QOL (p < 0.001): moderate to large effects • Significant improvements in SEPA scores (p < 0.001) • Daily moderate-to-vigorous PA (p = 0.04) • Reduced body weight and BMI (both, p < 0.001). |
• Use rate: 76%, • Adoption rate: 69% • Patients’ perception of app quality: satisfaction (positive NPS) • Barriers: absence of some food items • Facilitators: relevant information to the patient |
|
| McCarroll et al. (2014) [34] | BL | 1 months | • FACT-G • WEL •Anthropometrics (BMI, weight, waist circumference) • Daily food intake • PA minutes |
• Significant reductions in anthropometric factors including weight, BMI, and waist circumference (p < 0.0006) between pre- and postintervention • Significant improvement in total WEL score (p = 0.043) between pre- and postintervention • No significant differences in FACT-G, macronutrient consumption, and PA patterns |
||
| Lee et al. (2014) [32] | BL | 3 months | • Intensity aerobic exercise • Intake of F&V • DQI • EORTC QLQ-C30 • HADS • BFI • Stage of change • Perceived self-efficacy |
• Significantly increased moderate-intensity aerobic exercise for at least 150 min per week (p < 0.0001) and eating five servings of F&V per day (p = 0.001) in the intervention group • Greater improvement in overall diet quality in the intervention group compared to that in the control group (p = 0.001) • Significantly higher proportions of patients in whom protein and calcium intake met the RDA in the intervention group than those in the control group (respectively, p = 0.016, 0.003) • Significantly improved physical functioning (p = 0.023) and appetite loss (p = 0.034) of QOL, severity of fatigue (p = 0.032) in the intervention group compared to those in the control group • Significant improvement in stage of behavior change for exercise (p < 0.0001) and F&V consumption (p = 0.029) in the intervention group than those in the control group • Significant difference in self-efficacy for exercise management and F&V intake (p = 0.024 and p = 0.023, respectively) |
• Adherence rate: 89% • Positive evaluations of the contents, the IT-supported delivery method, and the system’s usefulness |
|
ACT: Auditory Consonant Trigrams, BFI: Brief Fatigue Inventory, BL: Baseline, BMI: body mass index, BPI: Brief Pain Inventory, BSI-GSI: Brief Symptom Inventory-Global Severity Index, CES-D: Center for Epidemiologic Studies Depression Scale, CI: confidence interval, CIS: Checklist Individual Strength, CSD: Consensus Sleep Diary, CTXD: Cancer and Treatment Distress, DBAS-16: Dysfunctional Beliefs and Attitudes about Sleep-16, DQI: diet quality index, EMA: early morning awakening, EORTC QLQ-C30: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, EPIC: Expanded Prostate Cancer Index Composite-26, FACIT-F: Functional Assessment of Cancer Therapy-Fatigue Scale, FACIT-Sp-Ex: Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Expanded Scale, FACT-B: Functional Assessment of Cancer Therapy-Breast, FACT-Cog: Functional Assessment of Cancer Therapy-Cognition Scale, FACT-G: Functional Assessment of Cancer Therapy-General, FSI: Fatigue Symptom Inventory, F&V: fruits and vegetables, HADS: Hospital Anxiety and Depression Scale, IG: Intervention Group, IPAQ: International Physical Activity Questionnaire, ISI: Insomnia Severity Index, IT: Information Technology, LD: Live Delivery, MRS: Menopause Rating Scale, NA: number of nocturnal awakenings, NPS: Net Promoter Score, PA: physical activity, PEPPI: Perceived Efficacy in Patient-Physician Interactions, PSQI: Pittsburgh Sleep Quality Index, QOL: Quality of Life, RDA: Recommended Daily Allowances, RPE: Ratings of Perceived Exertion scale, R-PFS: Revised-Piper Fatigue Scale-revised, RR: Relative Risks, SCL-90-R: Symptom Checklist-90-R depression scale, SE: sleep efficiency, SF-36: Short-Form 36 Health Survey, SEPA: Self-Efficacy scale for Physical Activity, SOL: Sleep Onset Latency, SQUASH: Short Questionnaire to Assess Health Enhancing Physical Activity, TD: Telemedicine Delivery, TIB: Time In Bed, TMT: Trail Making Test, TST: Total Sleep Time, WASO: Wake After Sleep Onset, WEL: Weight Efficacy Lifestyle Questionnaire, WL: Waitlist, 6MWT: 6-Min Walk Test.