Digital supportive care in prostate cancer: a systematic review

To map and synthesise the existing evidence on people's perspectives and requirements for patient-facing digital health technologies for use in prostate cancer care delivery. Understanding the preferences of people with prostate cancer and understanding the barriers and facilitators to maximising engagement with digital supportive care healthcare landscape.

Four electronic databases were searched to identify suitable studies. All identified citations were imported into Covidence systematic review software for the removal of duplicate records and the study selection process by two reviewers. Methodological quality was appraised using the MMAT, and findings were synthesised narratively using the Human, Organisation, and Technology-fit (HOT-fit) evaluation framework.

Eighty-eight studies were included and represented a total of 29,256 participants affected by prostate cancer. Preferences for digital supportive care emerged across four interconnected domains: (1) mode of delivery, (2) type of content desired, (3) factors enabling engagement, and (4) barriers limiting use. Overall, there was willingness to engage with digital models due to their convenience, flexibility, and immediacy of access. Self-management was enhanced via decision aids, symptom management tools, informational resources, and evidence-based tools to support aspects of psychosocial functioning and emotional wellbeing, physical activity, and sexual health. Several barriers to the implementation and uptake of digital supportive care interventions were identified primarily relating to technology access, device compatibility, digital literacy, and emotional readiness.

Digital models in prostate cancer care were acceptable and valued for their convenience, flexibility, immediacy of access, tailored content, clinician support, and interactive features, and facilitated self-management through decision-making, symptom management, and informational and psychosocial support. Interpreted through the HOT-fit framework, their value depended on the fit between the technology, its users, and the care setting rather than on technological sophistication alone. Limited attention has been given to digital sexual wellbeing support, and further research is needed on engagement among people with low digital literacy, non-English speakers, and lower-income populations, and on the long-term sustainability of digital models.