Systematic review and meta-analysis of digital interventions for mental health in cancer patients and survivors.

Abstract

Digital health interventions (DHIs) are increasingly used to support mental health for cancer patients and survivors, yet previous reviews have not fully captured all relevant studies. We conducted a systematic review and meta-analysis to evaluate the effectiveness of DHIs in improving mental health outcomes in this population. Six electronic databases were searched, identifying 139 randomised controlled trials across 25 countries involving 19,233 participants. Social media-based (SMD = -0.78, moderate-certainty), mHealth (SMD = -0.68, moderate-certainty), telehealth (SMD = -0.54, low-certainty), virtual reality (SMD = -0.59, moderate-certainty) and combined web-based and telehealth interventions (SMD = -0.26, moderate-certainty) significantly reduced anxiety. For depression, social media-based (SMD = -0.80, moderate-certainty), telehealth (SMD = -0.67, moderate-certainty) and mHealth (SMD = -0.49, low-certainty) showed significant reductions. Psychological distress improved with mHealth (SMD = -0.75, moderate-certainty) and web-based interventions (SMD = -0.28, moderate-certainty). Web-based interventions also improved insomnia (SMD = -0.67, moderate-certainty) and sleep quality (SMD = -0.57, moderate-certainty). These results suggest that DHIs provide mental health benefits for cancer populations. Telehealth, mHealth, and social media programs reduce anxiety and depression, while web-based interventions are beneficial for psychological distress, insomnia, and sleep quality, with added benefits when combined with telehealth. Virtual reality also relieves anxiety symptoms.