• Seyedehtanaz Saeidzadeh, Vijayvardhan Kamalumpundi, Nai-Ching Chi, Rajeshwari Nair, and Stephanie Gilbertson-White.
• College of Nursing, University of Iowa, Iowa City, IA, USA.
• Palliat Med. 2021 Jun 1; 35 (6): 1020-1038.

BackgroundSymptom management is a critical aspect of comprehensive palliative care for people with advanced cancer. Web and mobile-based applications are promising e-Health modalities that can facilitate timely access to symptom management interventions for this population.AimTo evaluate the efficacy of web and mobile-based symptom management interventions in alleviating physical symptom burden in people with advanced cancer.DesignA systematic review and meta-analysis was conducted. PROSPERO ID = CRD42020155295.Data SourcesWe searched databases including PubMed, PsycINFO, and CINAHL from 1991 until 2019. Inclusion criteria were: adults with advanced cancer, web or mobile-based interventions targeting symptom management, and report of physical symptom data. Risk of bias was assessed using the ROBINS-I and RoB2. Using RevMan, standardized mean difference (SMD) and 95% confidence intervals were calculated. Heterogeneity was assessed using the I2 statistic. An assessment of interventions was conducted by evaluating the delivery mode, duration, and evaluation of application feature and theoretical elements.ResultsA total of 19 studies are included in the systematic review and 18 in the meta-analysis. Majority of the studies were deemed to have high risk of bias. Most of the interventions used a web-application for delivering their education (n = 17). While the interventions varied regarding duration and content, they were mainly guided by a symptom management theory. Web and mobile-based interventions significantly improved the overall physical symptom burden (SMD = -0.18; 95% CI = -0.28 to -0.09; I2 = 0%; p = 0.0002).ConclusionsWeb and mobile-based intervention are efficacious in decreasing the overall physical symptom burden in people with advanced cancer.

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