Chen Wenyu, Huang Jie, Cui Zhifang, Wang Lei, Dong Liang, Ying Weifeng, Zhang Ye
Department of Respiratory Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China.
Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China.
Ther Adv Chronic Dis. 2023 Feb 17;14:20406223231153097. doi: 10.1177/20406223231153097. eCollection 2023.
Pain is the most common cancer-related symptom, but it is often undertreated. Telemedicine is widely used in cancer treatment, but its effectiveness is uncertain.
We aimed to evaluate the impact of telemedicine intervention on pain in patients with cancer.
Methodological quality and risk-of-bias evaluation were conducted, and the sources of heterogeneity were explored through subgroup analysis and sensitivity analysis.
PubMed, Embase, Web of Science, Cochrane Library, and clinical trial databases were searched up to 16 August 2022. Randomized controlled trials of the impact of telemedicine intervention regarding pain in patients with cancer were included, and the results related to pain were extracted.
Twenty-one randomized controlled trials were selected from 1810 articles. A total of 1454 patients received telemedicine interventions, and 2213 received conventional medical services. Telemedical intervention had a positive effect on improving pain intensity [standard mean deviation (SMD) = -0.28, 95% confidence interval (CI): -0.49 to -0.06, = 0.01] and pain interference (SMD = -0.41, 95% CI: -0.54 to -0.28, < 0.00001), with statistical difference between the two groups. The subgroup analysis results showed that the telemedicine subgroup based on an application (SMD = -0.54, 95% CI: -0.91 to -0.18, = 0.004) and the subgroup with intervention time ⩾ 6 months (SMD = -0.33, 95% CI: -0.52 to -0.13, = 0.001), both demonstrated significant improvement regarding pain intensity, with significant statistical difference between the two groups. When the follow-up time was ⩾ 6 months, there was no significant difference (SMD = -0.24, 95% CI: -0.55 to 0.07, = 0.13).
Compared with conventional medical services, telemedicine intervention can improve the pain of patients with cancer and is effective and acceptable regarding symptom monitoring. Integrating telemedicine interventions into cancer pain management may be a feasible option. But its long-term effects still need to be confirmed with more high-quality randomized controlled trials in the future.
https://www.crd.york.ac.uk/PROSPERO/; CRD42022361990.
疼痛是最常见的癌症相关症状，但往往治疗不足。远程医疗在癌症治疗中广泛应用，但其有效性尚不确定。
我们旨在评估远程医疗干预对癌症患者疼痛的影响。
进行方法学质量和偏倚风险评估，并通过亚组分析和敏感性分析探索异质性来源。
检索截至2022年8月16日的PubMed、Embase、Web of Science、Cochrane图书馆和临床试验数据库。纳入关于远程医疗干预对癌症患者疼痛影响的随机对照试验，并提取与疼痛相关的结果。
从1810篇文章中筛选出21项随机对照试验。共有1454例患者接受远程医疗干预，2213例接受传统医疗服务。远程医疗干预对改善疼痛强度[标准均数差（SMD）=-0.28，95%置信区间（CI）：-0.49至-0.06，P=0.01]和疼痛干扰（SMD=-0.41，95%CI：-0.54至-0.28，P<0.00001）有积极作用，两组间有统计学差异。亚组分析结果显示，基于应用的远程医疗亚组（SMD=-0.54，95%CI：-0.91至-0.18，P=0.004）和干预时间≥6个月的亚组（SMD=-0.33，95%CI：-0.52至-0.13，P=0.001），在疼痛强度方面均显示出显著改善，两组间有显著统计学差异。当随访时间≥6个月时，无显著差异（SMD=-0.24，95%CI：-0.55至0.07，P=0.13）。
与传统医疗服务相比，远程医疗干预可改善癌症患者的疼痛，在症状监测方面有效且可接受。将远程医疗干预纳入癌症疼痛管理可能是一种可行的选择。但其长期效果仍需未来更多高质量随机对照试验予以证实。
