Health Sciences Review (Sep 2022)

The effectiveness of nurse-led interventions for cancer symptom management 2000–2018: A systematic review and meta-analysis

  • Daniel Kelly,
  • Pauline Campbell,
  • Claire Torrens,
  • Andreas Charalambous,
  • Ulrika Östlund,
  • Manuela Eicher,
  • Maria Larsson,
  • Iveta Nohavova,
  • Cecilia Olsson,
  • Mhairi Simpson,
  • Elisabeth Patiraki,
  • Lena Sharp,
  • Theresa Wiseman,
  • Wendy Oldenmenger,
  • Mary Wells

Journal volume & issue
Vol. 4
p. 100052

Abstract

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Background: Evidence for effectiveness of nurse-led interventions for cancer-related symptoms is of variable quality. This study aimed to identify, appraise and evaluate the nature and effectiveness of nurse-led interventions on symptoms for people with cancer. Methods: A systematic review and meta-analysis. Ten major databases were searched (2000 to 2018, no language restrictions). Two reviewers applied a priori selection criteria; data extraction included design, population, cancer type, and cancer-related symptoms. Interventions and providers were profiled using TIDieR reporting guidelines, and content analysis of components. Methodological quality was assessed using Cochrane risk of bias. A meta-analysis was performed using mean and standardised mean differences with 95% confidence intervals. Overall certainty was assessed using GRADE. Results: From 29193 records, 149 studies (n = 107286 participants) from 22 countries were eligible. Interventions included multiple components; education and psychological approaches dominated. Pooled meta-analyses found evidence of benefit for nurse-led interventions on measures of constipation (MD −4.54, 95% CI −8.08 to −0.99; 645 participants; 6 trials; I2 = 0%; P = 0.01); nausea and vomiting (MD −1.97, 95% CI −3.61 to −0.33; 957 participants; 8 trials; I 2 = 12%; P = 0.02) and fatigue (MD −4.63, 95% CI −7.97 to −1.30; 1208 participants; 11 trials; I2 = 34%; P = 0.007). Psychological morbidity (anxiety, depression, mood) also improved. However, few trials used consistent outcome measures, interventions were poorly defined, and certainty of evidence was low or very low. Conclusion: Nurse-led interventions improve specific cancer-related symptoms, including psychological morbidity. Enhanced reporting and collaboration to develop a minimum core dataset would strengthen the quality of evidence.

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