Abstract CN25
Background
Self-management interventions (SMIs) are designed with a view to empower people living beyond breast cancer and help them adjust to a new normal. Establishing the effectiveness of SMIs to promote patients’ health-related quality of life (HRQoL) after the end of primary treatment for early-stage breast cancer is key. We critically appraised and synthesised up-to-date published evidence to address this knowledge gap.
Methods
In line with PRISMA statement guidelines, we searched MEDLINE, EMBASE and CINAHL (search period 2010-2020) for peer-reviewed publications of randomised controlled trials (RCTs) of SMIs tested with adult patients after the end of primary treatment for early-stage breast cancer (I-III according to TNM taxonomy). Pre-specified selection criteria were applied to all retrieved records. Methodological quality and risk of bias in the RCTs were evaluated and findings integrated into a narrative critical synthesis of evidence.
Results
From a total of 503 records, we selected nine eligible RCTs that tested nine unique SMIs. Five SMIs were based on cognitive behaviour therapy (CBT). SMIs were mainly prescribed for 12 weeks, but optimal dosage cannot be confirmed currently. Eight SMIs targeted recipients’ decision-making and taking-action skills. Across RCTs, gains in one to four domains of HRQoL were reported. Current evidence derives from moderate-to-good quality RCTs. Regardless of methodological quality or self-management skills applied, the reviewed SMIs predominantly promoted recipients’ physical and functional well-being, but effect sizes were consistently small. SMIs informed by CBT and/or offered through recipient education were marginally more effective.
Conclusions
SMIs are potentially effective after primary treatment for breast cancer, although effect sizes are small and inconsistent across HRQoL domains. We recommend more rigorous development and testing, as well as co-creation with potential recipients from the early development stages or at the refinement phase.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.