Clinical Informatics Service, Hospital Clínic de Barcelona, Barcelona, Spain.
Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain.
JCO Clin Cancer Inform. 2024 May;8:e2400014. doi: 10.1200/CCI.24.00014.
To comprehensively synthesize the existing evidence concerning mHealth interventions for patients with breast cancer (BC).
On July 30, 2023, we searched PubMed, PsycINFO, and Google Scholar for articles using the following inclusion criteria: evaluation of mHealth interventions in patients with cancer, at least 30 participants with BC, randomized control trials or prospective pre-post studies, determinants of health (patient-reported outcomes [PROs] and quality of life [QoL]) as primary outcomes, interventions lasting at least 8 weeks, publication after January 2015. Publications were excluded if they evaluated telehealth or used web-based software for desktop devices only. The quality of the included studies was analyzed with the Cochrane Collaboration Risk of Bias Tool and the Methodological Index for Non-Randomized Studies.
We included 30 studies (20 focused on BC), encompassing 5,691 patients with cancer (median 113, IQR, 135.5). Among these, 3,606 had BC (median 99, IQR, 75). All studies contained multiple interventions, including physical activity, tailored information for self-management of the disease, and symptom tracker. Interventions showed better results on self-efficacy (3/3), QoL (10/14), and physical activity (5/7). Lifestyle programs (3/3), expert consulting (4/4), and tailored information (10/11) yielded the best results. Apps with interactive support had a higher rate of positive findings, while interventions targeted to survivors showed worse results. mHealth tools were not available to the public in most of the studies (17/30).
mHealth interventions yielded heterogeneous results on different outcomes. Identifying lack of evidence on clinical scenarios (eg, patients undergoing systemic therapy other than chemotherapy) could aid in refining strategic planning for forthcoming research endeavors within this field.
全面综合现有关于乳腺癌（BC）患者移动医疗干预措施的证据。
2023 年 7 月 30 日，我们检索了 PubMed、PsycINFO 和 Google Scholar，纳入了以下标准的文章：评估癌症患者移动医疗干预措施，至少 30 名 BC 患者，随机对照试验或前瞻性前后研究，健康决定因素（患者报告结局[PRO]和生活质量[QoL]）为主要结局，干预至少 8 周，2015 年 1 月后发表。如果研究评估远程医疗或仅使用基于网络的软件用于桌面设备，则排除研究。使用 Cochrane 协作风险偏倚工具和非随机研究方法学指数对纳入研究的质量进行分析。
我们纳入了 30 项研究（20 项专注于 BC），涵盖了 5691 名癌症患者（中位数 113，IQR，135.5）。其中 3606 名患者患有 BC（中位数 99，IQR，75）。所有研究均包含多种干预措施，包括体育活动、针对疾病自我管理的个性化信息和症状追踪器。干预措施在自我效能感（3/3）、生活质量（10/14）和体育活动（5/7）方面表现出更好的结果。生活方式计划（3/3）、专家咨询（4/4）和个性化信息（10/11）产生了最佳结果。具有互动支持的应用程序具有更高的阳性发现率，而针对幸存者的干预措施结果较差。在大多数研究中（30/30），移动医疗工具公众无法获得。
移动医疗干预措施在不同结局方面产生了不同的结果。确定在临床场景（例如，接受除化疗以外的系统治疗的患者）缺乏证据，可以帮助完善该领域未来研究工作的战略规划。
