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Factors Associated With Digital Intervention Engagement and Adherence in Patients With Cancer: Systematic Review.
Lucile Montalescot1, Louise Baussard1, Elodie Charbonnier1
1Laboratoire de Psychopathologie et Processus de Santé, Université Paris-Cité, Boulogne-Billancourt, France.
Journal of Medical Internet Research
|December 11, 2024
Summary
Patient adherence to digital cancer care interventions is complex. Comorbidities and low social support consistently reduce engagement, while other factors show mixed results, necessitating further research.
Area of Science:
- Oncology
- Digital Health
- Behavioral Science
Background:
- Digital interventions are crucial for cancer patient support, offering education, behavior change, and monitoring.
- Patient adherence and engagement with these self-help digital tools remain a significant challenge.
- Existing reviews lack a comprehensive exploration of diverse factors influencing adherence in cancer care.
Purpose of the Study:
- To systematically identify factors influencing adherence and engagement with digital interventions featuring self-help components in cancer care.
- To examine sociodemographic, psychosocial, health-related, and intervention-specific factors impacting patient use of digital health solutions.
- To synthesize evidence on determinants of adherence and engagement for optimizing digital cancer care.
Main Methods:
- A systematic literature search adhering to PRISMA guidelines was conducted across major databases (PubMed, Embase, Cochrane Library, PsycINFO) from January 2010 to September 2021.
- Included studies focused on adult cancer patients using digital interventions with self-help features.
- Extracted data were synthesized, categorizing influencing factors into sociodemographic, psychosocial, health-related, technology-related, and intervention-related aspects.
Main Results:
- Out of 9386 screened studies, 61 were included, covering diverse digital interventions and cancer types.
- Comorbidity consistently predicted lower adherence and engagement; higher social support was paradoxically linked to lower adherence/engagement.
- Sociodemographic and health-related factors showed mixed results, while intervention-specific factors yielded conflicting findings; women showed higher adherence/engagement in distress-focused interventions.
Conclusions:
- Adherence and engagement with digital cancer care interventions are multifaceted, influenced by a complex interplay of factors.
- Comorbidities and low social support emerge as consistent barriers, while other determinants present inconsistent associations.
- Standardizing outcome measures, investigating specific intervention features, and improving study quality are essential for optimizing digital health solutions in oncology.
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