TY  - JOUR
AU  - Lim, Dwight Su Chun
AU  - Kwok, Benedict
AU  - Williams, Patricia
AU  - Koczwara, Bogda
PY  - 2023
DA  - 2023/11/22
TI  - The Impact of Digital Technology on Self-Management in Cancer: Systematic Review
JO  - JMIR Cancer
SP  - e45145
VL  - 9
KW  - self-management
KW  - self-management support
KW  - self-management core skills
KW  - digital technology
KW  - digital health
KW  - mHealth
KW  - mobile health
KW  - eHealth
KW  - cancer
KW  - theoretical frameworks
KW  - predictors of effect
KW  - chronic disease
KW  - skills
KW  - decision-making
KW  - cancer treatment
AB  - Background: Self-management (SM) plays an important role in supporting patients’ adaptation to and management of the symptoms of chronic diseases. Cancer is a chronic disease that requires patients to have responsibility in management. Digital technology has the potential to enhance SM support, but there is little data on what SM skills are most commonly supported by digital technology. Objective: This review aimed to examine the SM core skills that were enabled and supported by digital interventions in people with cancer and identify any predictors of the effect of digital health intervention on SM core skills. Methods: Three electronic databases (MEDLINE, Scopus, and CINAHL) were searched for papers, published from January 2010 to February 2022, that reported randomized controlled trials (RCTs) involving patients with cancer or survivors of cancer where a digital technology intervention was evaluated and change in 1 or more SM core skills was a measured outcome. Results: This systematic review resulted in 12 studies that were eligible to identify which SM core skills were enabled and supported by digital intervention. The total number of participants in the 12 studies was 2627. The most common SM core skills targeted by interventions were decision-making, goal setting, and partnering with health professionals. A total of 8 (67%) out of 12 RCTs demonstrated statistically significant improvement in outcomes including self-efficacy, survivorship care knowledge and attitude, quality of life, increased knowledge of treatment, and emotional and social functioning. A total of 5 (62%) out of 8 positive RCTs used theoretical considerations in their study design; whereas in 1 (25%) out of 4 negative RCTs, theoretical considerations were used. In 3 studies, some factors were identified that were associated with the development of SM core skills, which included younger age (regression coefficient [RC]=–0.06, 95% CI –0.10 to –0.02; P=.002), computer literacy (RC=–0.20, 95% CI –0.37 to –0.03; P=.02), completing cancer treatment (Cohen d=0.31), male sex (SD 0.34 in social functioning; P=.009), higher education (SD 0.19 in social functioning; P=.04), and being a recipient of chemotherapy (SD 0.36 in depression; P=.008). In all 3 studies, there were no shared identical factors that supported the development of SM core skills, whereby each study had a unique set of factors that supported the development of SM core skills. Conclusions: Digital technology for patients with cancer appears to improve SM core skills including decision-making, goal setting, and partnering with health care partners. This effect is greater in people who are younger, male, educated, highly computer literate, completing cancer treatment, or a recipient of chemotherapy. Future research should focus on targeting multiple SM core skills and identifying predictors of the effect of digital technology intervention. Trial Registration: PROSPERO CRD42021221922; https://tinyurl.com/mrx3pfax 
SN  - 2369-1999
UR  - https://cancer.jmir.org/2023/1/e45145
UR  - https://doi.org/10.2196/45145
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37991831
DO  - 10.2196/45145
ID  - info:doi/10.2196/45145
ER  -