Effects of Remote Web-Based Interventions on the Physiological and Psychological States of Patients With Cancer: Systematic Review With Meta-Analysis

BackgroundPatients with cancer may experience physiological and psychological adverse reactions, such as fatigue, pain, anxiety, and depression, which seriously affect their quality of life. Research has shown that remote interventions based on apps or miniprograms may help improve the physiological and mental health of patients with cancer. However, due to the limited number of relevant studies, the impact of web-based interventions in cancer management remains unclear. ObjectiveWe aimed to determine the efficacy of interventions based on apps, miniprograms, or other web-based tools on the physiological (body pain and fatigue) and psychological (anxiety and depression) states and the quality of life of patients with cancer. MethodsWe conducted electronic literature searches in PubMed, Scopus, Web of Science, the Cochrane Library, CINAHL, and EMBASE databases. The search period spanned from the inception of each database to October 15, 2024. Two researchers independently conducted literature retrieval and data extraction. The risk of bias was assessed with the Cochrane risk-of-bias tool, and the quality of evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). All statistical analyses were performed using Review Manager version 5.4. ResultsA total of 36 randomized controlled trials were included. The remote web-based interventions significantly improved the pain intensity (n=14, 39% studies; standardized mean difference [SMD] –0.39, 95% CI –0.64 to –0.14; I2=82%; GRADE rating=low) and fatigue status (n=11, 31% studies; SMD –0.52, 95% CI –0.95 to –0.09; I2=95%; GRADE rating=low) in patients with cancer. Regarding psychology, the results indicated that the remote web-based interventions significantly improved the anxiety (n=14, 39% studies; SMD –0.60, 95% CI –0.90 to –0.30; I2=91%; GRADE rating=low) and depressive state (n=10, 28% studies; SMD –0.36, 95% CI –0.58 to –0.14; I2=81%; GRADE rating=low) of patients with cancer. For quality of life, the results showed that the remote web-based interventions had a significant positive impact on the quality of life of patients with cancer (n=26, 72% studies; SMD 0.63, 95% CI 0.39-0.87; I2=92%; GRADE rating=low). ConclusionsThe remote web-based interventions were effective in reducing the intensity of physiological pain, relieving fatigue, improving depression and anxiety, and improving the quality of life of patients with cancer. However, due to the low certainty of evidence, more rigorous randomized controlled trials are needed to validate these findings further. Trial RegistrationPROSPERO CRD42024611768; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024611768