A Systematic Review of Communication Tools to Improve Reproductive and Sexual Health Outcomes in Female Cancer Patients Identified Significant Gendered Data Gaps in Care

• Published in: Blood 2024-11, Vol.144, p.618-618
• Main Authors: Bhati, Anirudh Singh, Anazodo, Antoinette, Chadwick, Verity, Rodgers, Racheal, Dear, Rachel, Hamad, Nada
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-204768

Introduction Female patients with cancer (including blood cancer) are particularly at risk of having their reproductive concerns neglected. Despite the considerable impact of cancer, includingblood cancers, and their treatment on sexual health, healthcare professionals frequently face barriers in discussing these changes. This study reviewed the tools that facilitate communication with female patients of childbearing age regarding their reproductive needs with healthcare professionals. The scope of this review includes fertility preservation, menstrual disturbances, contraceptive use, and sexual dysfunction. Methods A systematic search of PubMed, Embase, and PsycInfo databases for interventional studies was conducted until May 2024. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of relevant studies. Data were extracted using standardized collection sheets, summarized in a narrative synthesis, and visualized in tables. Results The search yielded 2435 studies published between 2001 and 2024, of which 14 met the inclusion criteria. All studies had a quantitative design, with 13 randomised controlled trials (RCTs). Eleven unique interventions were described, with the most common tool being the PLISSIT (permission, limited information, specific suggestions, and intensive therapy) stepwise counselling model. Three studies used online web-based fertility preservation decision aids, two investigated educational programs, and the remaining nine used trialled counselling models. A total of 41 different measurement instruments were used to report the outcomes. Outcomes related to fertility and sexual dysfunction were reported in six and ten studies, respectively, with some overlapping themes. Only one study explored contraception and menstrual disturbances. Ten studies reported statistically significant improvements in reproductive outcomes. The tools used included decision aids, web-based and print education programs, and communication models that were integrated into counselling. The interventions were applied in individualized, group-based, coupled, and mixed settings. In facilitating discussions of fertility preservation, the psycho-educational couples' counselling model (O!PEACE) and web-based decision aids were effective. The O!PEACE intervention significantly improved knowledge compared to the control and yielded a significant increase in patients receiving fertility preservation care through increased fertility preservation consultat