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Self-management education interventions for patients with cancer: a systematic review

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Abstract

Purpose

This systematic review was intended to identify the effectiveness and inclusion of essential components of self-management education interventions to support patients with cancer in developing the skills needed for effective self-management of their disease and the acute or immediate, long-term, and late harmful effects of treatments.

Methods

Self-management education interventions were included if they were randomized controlled trials (RCTs) containing at least one of the eight core elements outlined by the research team. A systematic search was conducted in Ovid MEDLINE (2005 through April 2015), Embase (2005 to 2015, week 15), the Cochrane Database of Systematic Reviews (Issue 4, April 2015), CINAHL (2005 to 2015) and PsychINFO (2005 to 2015). Keywords searched include ‘self-management patient education’ or ‘patient education’.

Results

Forty-two RCTs examining self-management education interventions for patients with cancer were identified. Heterogeneity of interventions precluded meta-analysis, but narrative qualitative synthesis suggested that self-management education interventions improve symptoms of fatigue, pain, depression, anxiety, emotional distress and quality of life. Results for specific combinations of core elements were inconclusive. Very few studies used the same combinations of core elements, and among those that did, results were conflicting. Thus, conclusions as to the components or elements of self-management education interventions associated with the strength of the effects could not be assessed by this review.

Conclusion

Defining the core components of cancer self-management education and the fundamental elements for inclusion in supporting effective self-management will be critical to ensure consistent and effective provision of self-management support in the cancer system.

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Acknowledgements

We would like to extend our appreciation to the researchers who conducted the studies included in this review and the patients with cancer who participated in them. We would also like to thank the Program in Evidence-Based Care (PEBC) for their support and guidance in conducting this research.

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Authors and Affiliations

  1. University Health Network, Princess Margaret Cancer Center and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    Doris Howell

  2. Provincial Head Patient Education, Cancer Care Ontario, Toronto, ON, Canada

    Tamara Harth

  3. Program in Evidence-Based Care, McMaster University, Hamilton, ON, Canada

    Judy Brown

  4. Hamilton Health Sciences, Juravinski Cancer Centre, Hamilton, ON, Canada

    Cathy Bennett

  5. Northeast Cancer Centre, Sudbury, ON, Canada

    Susan Boyko

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  1. Doris Howell
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Correspondence to Judy Brown.

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Conflict of interest

The authors and members of the expert panel from the Program in Evidence-Based Care, McMaster University, Hamilton, ON, Canada and the Cancer Care Ontario, Patient Education Program, Toronto, ON, Canada reported that they had no conflicts of interest.

Funding

The PEBC is a provincial initiative of Cancer Care Ontario supported by the Ontario Ministry of Health and Long-Term Care. All work produced by the PEBC is editorially independent from the Ontario Ministry of Health and Long-Term Care.

Additional information

Doris Howell and Tamara Harth were co-chairs for this evidence summary.

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Howell, D., Harth, T., Brown, J. et al. Self-management education interventions for patients with cancer: a systematic review. Support Care Cancer 25, 1323–1355 (2017). https://doi.org/10.1007/s00520-016-3500-z

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