Mitsis Alexandros, Filis Panagiotis, Karanasiou Georgia, Georga Eleni I, Mauri Davide, Naka Katerina K, Constantinidou Anastasia, Keramida Kalliopi, Tsekoura Dorothea, Mazzocco Ketti, Alexandraki Alexia, Kampouroglou Effrosyni, Goletsis Yorgos, Papakonstantinou Andri, Antoniades Athos, Brown Cameron, Bouratzis Vasileios, Matos Erika, Marias Kostas, Tsiknakis Manolis, Fotiadis Dimitrios I
Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, 45110 Ioannina, Greece.
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece.
Cancers (Basel). 2025 May 26;17(11):1780. doi: 10.3390/cancers17111780.
The prevalence of breast cancer (BC) is significant globally. The malignancy itself and the related treatments have a considerable impact on patients' overall well-being. The adoption of e-health solutions for patients is increasing rapidly worldwide, since these innovative tools hold significant potential to positively impact the mental health and quality of life (QoL) of BC patients. However, their overall impact is still being explored, and further understanding and analysis are required. This review paper aims to present, quantify, and summarize the cumulative available randomized evidence on the state of the art of supportive interventions delivered via e-health applications for patients' mental health and QoL before, during, and after BC treatment. : A systematic review was conducted following the PRISMA guidelines in the Scopus and PubMed databases on 7 November 2024 to identify studies that utilized internet-based interventions in BC patients. The inclusion criteria were as follows: adult men and women (aged > 18 years) diagnosed with breast cancer (BC) who received patient-directed e-health interventions, compared to standard care or control interventions. The studies had to focus on outcomes such as quality of life (QoL), anxiety, depression, and distress, and be limited to randomized controlled trials (RCTs). The PRISMA-P guidelines were followed. Risk of bias was assessed using the Cochrane risk-of-bias (RoB) tool for randomized controlled trials. : A total of 27 randomized studies, involving 2898 patients, were included in this systematic review. The e-health interventions significantly affected patients' anxiety (SMD = -0.80; 95% CI: -1.33 to -0.27; < 0.01; and I = 94%), depression (SMD = -0.74; 95% CI: -1.40 to -0.09; = 0.026; and I = 95%) and QoL (SMD = 0.65; 95% CI: 0.27 to 1.04; < 0.01; and I = 90%) but had no significant effect on distress (SMD = -0.78; 95% CI: -1.93 to 0.37; = 0.184; and I = 95%). : This study showed that e-health interventions can improve QoL, reduce anxiety, and decrease depression in adult BC patients. However, no noticeable impact on reducing distress levels was observed. Additionally, given the diversity of interventions, these results should be interpreted with caution. To determine the optimum duration, validate different intervention approaches, and address methodological gaps in previous studies, more extensive clinical studies are needed.
乳腺癌（BC）在全球范围内的患病率颇高。这种恶性肿瘤本身以及相关治疗对患者的整体健康状况有相当大的影响。在全球范围内，针对患者的电子健康解决方案的采用正在迅速增加，因为这些创新工具具有显著潜力，能够对乳腺癌患者的心理健康和生活质量（QoL）产生积极影响。然而，它们的总体影响仍在探索之中，需要进一步的理解和分析。这篇综述文章旨在呈现、量化并总结关于通过电子健康应用为乳腺癌患者治疗前、治疗期间和治疗后提供支持性干预的现有随机证据。：2024年11月7日，我们按照PRISMA指南在Scopus和PubMed数据库中进行了一项系统综述，以识别在乳腺癌患者中使用基于互联网干预措施的研究。纳入标准如下：成年男性和女性（年龄>18岁），被诊断患有乳腺癌（BC），接受针对患者的电子健康干预，与标准护理或对照干预进行比较。这些研究必须关注生活质量（QoL）、焦虑、抑郁和痛苦等结果，并且仅限于随机对照试验（RCTs）。遵循PRISMA - P指南。使用Cochrane随机对照试验偏倚风险（RoB）工具评估偏倚风险。：本系统综述共纳入27项随机研究，涉及2898名患者。电子健康干预对患者的焦虑（标准化均数差[SMD]= - 0.80；95%置信区间[CI]：- 1.33至 - 0.27；P<0.01；异质性指数[I]=94%）、抑郁（SMD = - 0.74；95% CI：- 1.40至 - 0.09；P = 0.026；I = 95%）和生活质量（SMD = 0.65；95% CI：0.27至1.04；P<0.01；I = 90%）有显著影响，但对痛苦没有显著影响（SMD = - 0.78；95% CI：- 1.93至0.37；P = 0.184；I = 95%）。：本研究表明，电子健康干预可以改善成年乳腺癌患者的生活质量，减轻焦虑并降低抑郁程度。然而，未观察到对降低痛苦水平有明显影响。此外，鉴于干预措施的多样性，对这些结果的解释应谨慎。为了确定最佳持续时间，验证不同的干预方法，并解决先前研究中的方法学差距，需要进行更广泛的临床研究。
