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Effect of telehealth interventions on adherence to endocrine therapy among patients with breast cancer: a systematic review and meta-analysis

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Abstract

Purpose

To evaluate the effect of telehealth interventions on adherence to endocrine therapy among patients with breast cancer.

Methods

A systematic search of five English databases (PubMed, Web of Science, Embase, the American Psychological Association PsycNet, and the Cochrane Library) and four Chinese databases (Chinese National Knowledge Infrastructure, SinoMed, WanFang Data, and WeiPu Data) was performed from inception to March 31, 2023. Two investigators independently screened the available studies for eligibility and extracted relevant data. Quality assessment was conducted using the Cochrane Risk of Bias Tool. The effect size was computed based on the risk ratio for dichotomous data and standardized mean difference for continuous data using Review Manager 5.4.

Results

A total of 1,780 participants from eight randomized controlled trials were included. These studies involved treatment with aromatase inhibitors only (n = 3) or aromatase inhibitors plus tamoxifen (n = 5). Telehealth interventions involved web-based interventions, telephone-based interventions, interventions via mobile applications, and interventions based on technology. In three studies, subjective measures were used, while objective measures were utilized in another three. Two studies incorporated a combination of both subjective and objective measures. The duration of the interventions varied among studies, ranging from a week to 36 months. The follow-up duration ranged from 4 weeks to 36 months. The quality of included studies was moderate to high. The meta-analysis of the five studies reporting dichotomous data showed that telehealth interventions had a significant effect on adherence to endocrine therapy (RR = 0.86, 95% CI = 0.76–0.97). Moreover, four studies reported continuous data. The meta-analysis demonstrated that telehealth interventions significantly improved adherence to endocrine therapy at 1 month (SMD = 0.50, 95% CI = 0.10–0.90), 3 months (SMD = 0.58, 95% CI = 0.17–0.99), and 6 months (SMD = 0.27, 95% CI = 0.08–0.47) of follow-up.

Conclusion

Telehealth interventions may facilitate adherence to endocrine therapy among patients with breast cancer. Further research should adopt a theory-based design and explore the longer-term effects.

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Data availability

The data that supported the analysis in this review were all extracted from the original studies. All data relevant to the study are included in the article.

Code availability

Not applicable.

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Acknowledgements

The authors would like to be thankful to the National Natural Science Foundation of China for the fund support.

Funding

This study was supported by the National Natural Science Foundation of China (Grant number: 71974218).

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Authors and Affiliations

  1. School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan 2nd Rd, Guangzhou, 510080, China

    Shihao Sun, Baoyi Zhang, Ni Zhang, Yiheng Zhang, Mengyao Zhu & Meifen Zhang

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Contributions

Conceptualization: MFZ.

Acquisition of data: SHS and BYZ.

Analysis and/or interpretation of data: SHS and MYZ.

Drafting the manuscript: SHS and BYZ.

Revising the manuscript critically for important intellectual content: MYZ, NZ and YHZ.

Data validation: SHS, NZ, YHZ and MYZ.

Supervision: MFZ.

Corresponding author

Correspondence to Meifen Zhang.

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Shihao Sun and Baoyi Zhang are joint first authors and contributed equally to this paper.

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Sun, S., Zhang, B., Zhang, N. et al. Effect of telehealth interventions on adherence to endocrine therapy among patients with breast cancer: a systematic review and meta-analysis. Support Care Cancer 32, 151 (2024). https://doi.org/10.1007/s00520-024-08339-z

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