Psychosocial Impact of Virtual Cancer Care through Technology: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

SIMPLE SUMMARY: Modern technology now enables the remote delivery of cancer care, often called telemedicine. Despite the many potential advantages, it is still not known whether a lack of in-person contact with clinicians may affect the psychosocial health of cancer patients. This systematic review and meta-analysis aimed to determine whether totally or partially replacing conventional face-to-face hospital care with telemedicine deteriorates quality of life, anxiety, psychological distress, or depression of adult people with cancer. The results of the eight included randomized trials seem to indicate that telemedicine does not worsen psychosocial health. On the contrary, we observed improvements in favor of telemedicine in all considered outcomes. Possible explanations are that technology improves access to information and facilitates contact with clinicians, and that being followed at home reduces uneasiness. Future research should identify which patients may benefit from telemedicine, and those for whom traditional in-person visits remain the best option. ABSTRACT: This meta-analysis of RCTs aimed to determine whether replacing face-to-face hospital care with telemedicine deteriorates psychosocial outcomes of adult cancer patients, in terms of quality of life (QoL), anxiety, distress, and depression. RCTs on interventions aimed at improving patient psychosocial outcomes were excluded. MEDLINE, EmBASE, and PsycInfo were searched on 13 May 2022 without language or date restrictions. In total, 1400 records were identified and 8 RCTs included (4434 subjects). Study methodological quality was moderate. Statistically significant improvements were observed in favor of the intervention for QoL (SMD = 0.22, 95% CI 0.01 to 0.43, p = 0.04), anxiety (SMD = −0.17, 95% CI −0.30 to −0.04, p < 0.01), and global distress (SMD = −0.38, 95% CI −0.51 to −0.25, p < 0.01). A meta-analysis on depression could not be performed. In subgroup analyses, the intervention appeared to be more beneficial for patients receiving active treatment vs. follow-up, for “other cancer types” vs. breast cancer, and for “other modes of administration” vs. telephone. Given the many potential advantages of being assisted at home, telemedicine appears to be a viable option in oncology. However, more research is necessary to determine the types of patients who may benefit the most from these alternative care modalities.