Online Psychological intervention in Breast Cancer Survivors: a Review

Abstract

Introduction: Online psychotherapy has shown promise in a variety of settings. The goal of this review was to compare outcomes following online psychotherapy in breast cancer survivors. Methods: We searched Ovid MEDLINE for randomised controlled trials investigating the benefit of online psychotherapy relative to controls in breast cancer survivors. We sought to capture data on a standardised pre- and post-intervention symptom scale. Baseline characteristics were collected, including highest education level achieved, breast cancer treatment, and description and duration of the psychosocial intervention. Trials were stratified based on behavioural or psychological indications for treatment. Effect sizes were computed using Cohen’s d. Results: From an initial search of 99 articles, 838 participants across five relevant studies were included. The mean age of the women was 51.7 years (range, 50.2-56.9). Each study had a unique indication: insomnia, fatigue, sexual dysfunction, psychological adjustment, and stress management. Two primary and one secondary outcome were recorded for each study, for a total of 15. Of the 10 included primary outcomes, women in the intervention groups showed a statistically significant improvement in nine outcomes. Of the five secondary outcomes, women in the intervention groups showed a significant improvement on four scales. Effect sizes ranged from 0.33 to 1.10. Conclusion: Overall, online psychotherapies are effective across a variety of symptom states in breast cancer survivors. Limitations of online psychotherapy include logistical factors, privacy, personal factors, and availability. Future studies should compare in-person psychotherapy with online psychotherapy.