van Deursen Liza, Versluis Anke, van der Vaart Rosalie, Standaar Lucille, Struijs Jeroen, Chavannes Niels, Aardoom Jiska J
Department of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.
JMIR Cancer. 2022 Jun 14;8(2):e37093. doi: 10.2196/37093.
Globally, the burden of cancer on population health is growing. Recent trends such as increasing survival rates have resulted in a need to adapt cancer care to ensure a good care experience and manageable expenditures. eHealth is a promising way to increase the quality of cancer care and support patients and survivors.
The aim of this systematic review was 2-fold. First, we aimed to provide an overview of eHealth interventions and their characteristics for Dutch patients with and survivors of cancer. Second, we aimed to provide an overview of the empirical evidence regarding the impact of eHealth interventions in cancer care on population health, quality of care, and per capita costs (the Triple Aim domains).
The electronic databases Web of Science, PubMed, Cochrane, and Ovid PsycINFO were searched using 3 key search themes: eHealth interventions, cancer care, and the Netherlands. The identified interventions were classified according to predetermined criteria describing the intervention characteristics (eg, type, function, and target population). Their impact was subsequently examined using the Triple Aim framework.
A total of 38 interventions were identified. Most of these were web portals or web applications functioning to inform and self-manage, and target psychosocial factors or problems. Few interventions have been tailored to age, disease severity, or gender. The results of this study indicate that eHealth interventions could positively affect sleep quality, fatigue, and physical activity of patients with and survivors of cancer. Inconclusive results were found regarding daily functioning and quality of life, psychological complaints, and psychological adjustment to the disease.
eHealth can improve outcomes in the Triple Aim domains, particularly in the population health and quality of care domains. Cancer-related pain and common symptoms of active treatment were not targeted in the included interventions and should receive more attention. Further research is needed to fully understand the impact of eHealth interventions in cancer care on participation, accessibility, and costs. The latter can be examined in economic evaluations by comparing eHealth interventions with care as usual.
在全球范围内，癌症对人群健康的负担正在增加。生存率上升等近期趋势导致需要调整癌症护理，以确保良好的护理体验和可控的支出。电子健康是提高癌症护理质量并支持患者和幸存者的一种有前景的方式。
本系统评价的目的有两个。首先，我们旨在概述针对荷兰癌症患者及其幸存者的电子健康干预措施及其特征。其次，我们旨在概述有关电子健康干预措施在癌症护理中对人群健康、护理质量和人均成本（三重目标领域）影响的实证证据。
使用三个关键搜索主题在电子数据库Web of Science、PubMed、Cochrane和Ovid PsycINFO中进行搜索：电子健康干预措施、癌症护理和荷兰。根据描述干预特征（如类型、功能和目标人群）的预定标准对确定的干预措施进行分类。随后使用三重目标框架检查其影响。
共确定了38项干预措施。其中大多数是用于提供信息和自我管理的门户网站或网络应用程序，目标是心理社会因素或问题。很少有干预措施针对年龄、疾病严重程度或性别进行调整。本研究结果表明，电子健康干预措施可对癌症患者及其幸存者的睡眠质量、疲劳和身体活动产生积极影响。在日常功能和生活质量、心理抱怨以及对疾病的心理适应方面，结果尚无定论。
电子健康可以改善三重目标领域的结果，特别是在人群健康和护理质量领域。纳入的干预措施未针对癌症相关疼痛和积极治疗的常见症状，应给予更多关注。需要进一步研究以充分了解电子健康干预措施在癌症护理中对参与度、可及性和成本的影响。后者可通过将电子健康干预措施与常规护理进行比较的经济评估来检验。
