Improving quality of life and symptom experience in patients with metastatic breast cancer: A systematic review of supportive care interventions

• Published in: Psycho-oncology (Chichester, England) England), 2023-08, Vol.32 (8), p.1192-1207
• Main Authors: Keane, Danielle, Phillips, Grace, Mitchell, Nicola, Connolly, Roisin M., Hegarty, Josephine
• Format: Article
• Language: English
• Subjects: advanced breast cancer; Breast cancer; Breast Neoplasms - psychology; Breast Neoplasms - therapy; Citations; Drugs; End of life decisions; Exercise; Female; Humans; Intervention; interventions; Medical prognosis; Metastasis; oncology; Physical activity; Psychosocial factors; Quality of Life; Risk assessment; supportive care; Systematic review
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.6183

Objective The prognosis for individuals with metastatic breast cancer (MBC) has improved in recent decades. This expanding cohort has unique psychological and psychosocial needs, yet targeted supportive care interventions are underdeveloped. This systematic review seeks to summarise the available evidence on the effectiveness of supportive care interventions in improving quality of life and symptom experience of individuals living with MBC so that services can be developed to address the unmet needs of this cohort in future. Methods Academic Search Complete, CINAHL, ERIC, Medline and SocINDEX were searched for publications investigating the effect of supportive care interventions specifically targeted at addressing the quality of life or symptom experience of individuals living with MBC. Three reviewers independently screened and selected studies. Quality appraisal and assessed risk of bias were carried out. Results The search yielded 1972 citations. Thirteen studies met the inclusion criteria. Interventions included psychological (n = 3), end of life discussion and preparation (n = 2), physical activity (n = 4), lifestyle (n = 2), and medication self‐management support (n = 2). Three studies reported significant improvement in quality of life, two of which reported improved symptom experience in at least one symptom. Three further physical activity interventions showed improvement in at least one of the symptoms investigated. Conclusion Studies reporting a statistically significant effect on quality of life and improved symptom experience were extremely heterogenous. We can tentatively suggest that multimodal and frequently administered interventions are effective, with physical activity interventions positively impacting on symptom experience, however further research is required.