Supportive Care in Cancer

, Volume 26, Issue 2, pp 361–374 | Cite as

Effectiveness of Internet-based interventions in managing chemotherapy-related symptoms in patients with cancer: a systematic literature review

  • S. Moradian
  • N. Voelker
  • C. Brown
  • G. Liu
  • D. HowellEmail author
Review Article



The aims of this review were to (1) examine the effectiveness of Internet-based interventions on cancer chemotherapy-related physical symptoms (severity and/or distress) and health-related quality of life (HRQOL) outcomes and (2) identify the design elements and processes for implementing these interventions in oncology practices.


A systematic review was performed. The Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, CINAHL, and PsycINFO were searched for studies dating from January 2000 through to October 2016. Based on pre-determined selection criteria, data was extracted from eligible studies. Methodological quality of studies was assessed using an adapted version of the Cochrane Collaboration Back Review Group checklist.


The literature search yielded 1766 studies of which only six RCTs fulfilled the eligibility criteria. Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included tailored information, education, self-management support, and communication with clinicians. Five studies measured symptom distress and four of them reported statistically significant differences between study groups. Of the three studies that measured HRQOL, two reported improvement (or no deterioration over time) for the intervention group. However, several methodological issues including high attrition rates, poor adherence to interventions, and use of non-validated measures affect confidence in the strength of evidence.


Despite the evidence in support of using the Internet as a worthwhile tool for effective patient engagement and self-management of chemotherapy-related symptoms outside clinic visits, methodological limitations in the evidence base require further well-planned and quality research.


Internet-based intervention Implementation Symptom management Chemotherapy-related toxicity Patient engagement Cancer 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

We have full control of all primary data and agree to allow the journal to review our data if requested.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • S. Moradian
    • 1
  • N. Voelker
    • 2
  • C. Brown
    • 3
  • G. Liu
    • 4
  • D. Howell
    • 1
    • 5
    Email author
  1. 1.Psychosocial Oncology, Ontario Cancer InstituteUniversity of TorontoTorontoCanada
  2. 2.University of WaterlooWaterlooCanada
  3. 3.University Health NetworkTorontoCanada
  4. 4.Ontario Cancer Institute, Princess Margaret Cancer CareUniversity of TorontoTorontoCanada
  5. 5.Princess Margaret Cancer CareTorontoCanada

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