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Effects of eHealth for patients and informal caregivers confronted with cancer: a meta-review.

Slev, V.N., Mistiaen, P., Pasman, H.R.W., Verdonck-de Leeuw, I.M., Uden-Kraan, C.F. van, Francke, A.L. Effects of eHealth for patients and informal caregivers confronted with cancer: a meta-review. International Journal of Medical Informatics: 2016, 87, 54-67
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Background
eHealth can be defined as information provision about illness or health care and/or support for patients and/or informal caregivers, using the computer or related technologies. eHealth interventions are increasingly being used in cancer care, e.g. to support patients and informal caregivers in managing symptoms and problems in daily life.

Objectives
To synthesize evidence from systematic reviews on the effects of eHealth for cancer patients or their informal caregivers.

Materials and Methods
A systematic meta-review, in the sense of a systematic review of reviews, was conducted. Searches were performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. All steps in the review process were either performed by two reviewers independently or checked by a second reviewer. Disagreements were resolved by consensus.

Results
Ten systematic reviews were included. All reviews focused on the effects of eHealth for patients and none on effects for informal caregivers. Except for one review of high methodological quality, all reviews were of moderate methodological quality. Evidence was found for effects on perceived support, knowledge levels, and information competence of cancer patients. Indications of evidence were found for health status and healthcare participation. Findings were inconsistent for outcomes related to decision-making, psychological wellbeing, depression and anxiety, and quality of life. No evidence was found for effects on physical and functional wellbeing.

Conclusion
There is evidence for positive effects of eHealth on perceived support, knowledge, and information competence of cancer patients. For effects on other outcomes in cancer patients, findings are mainly inconsistent or lacking. This meta-review did not find relevant reviews focusing on or including the effects of eHealth on informal caregivers, which seems a rather unexplored area. (aut. ref.)