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Self-management education programs have some potential to manage physical and emotional pain among patients with cancer

Howell D, Harth F, Brown J, et al.  Self-management education interventions for patients with cancer: A systematic review Support Care Cancer. 2017 January; 25(4).

Review question

• Which self-management education programs help patients with cancer cope with the emotional and physical symptoms of the disease, and how effective are these programs?

Background

• In the U.S., the number of new cancer cases is expected to increase from 14.1 million annually in 2012 to 21.4 million in 2030.
• Better treatments have increased chances of patients surviving cancer, but the long-term needs of the growing number of cancer survivors is costly and putting increasing pressures on healthcare resources.
• Self-management education programs, which give patients the knowledge and skills needed to deal with symptoms of cancer, might allow patients to better manage the effects of cancer and reduce the strain on the healthcare system.

How the review was done

• A detailed search of five electronic databases for studies published from 2005 to 2015 was conducted. Studies that focused on a broad range of self-management education programs for adult patients suffering from cancer were included in the review.
• A total of 2,105 articles were identified in searches, and 45 studies were included in the review after assessments for eligibility.
• The review was funding by a Cancer Care Ontario initiative, which is supported by the Ontario Ministry of Health and Long-Term Care.

What the researchers found

• The review found that there was a lack of clarity on the core components of cancer self-management education programs, and that the existing research is not consistent in how self-management education programs are defined.
• Eleven studies looked at physical symptoms of cancer, including pain and fatigue, and found that self-management education programs helped lower fatigue levels for a significant number of patients, although little is known about whether these programs help reduce pain.
• While many studies looked at the emotional effects of cancer, few found any evidence about whether self-management education programs helped lower depression and anxiety levels.

Conclusion

• This review found that there is no clear definition of self-management education programs, with many studies focusing on different goals and aims. Some studies reported that self-management education programs helped reduce the physical and/or emotional impacts of pain, but there is not enough research available to confirm this approach is effective.