The effectiveness of e-Health interventions on caregiver burden, depression, and quality of life in informal caregivers of patients with cancer: A systematic review and meta-analysis of randomized controlled trials
Abstract
Background With the increasing incidence and survival rate of cancer, there are more people living with cancer, which increases the responsibilities of informal caregivers and results in a significant caregiver burden, depression, and low quality of life. The efficacy of e-Health interventions has already been proven in decreasing caregiver burden, addressing psychosocial concerns, and increasing quality of life among caregivers of patients with chronic diseases. However, the utilization of e-Health interventions on the informal caregivers of cancer patients is still limited and the effectiveness is unclear.Objectives To assess the impact of e-Health interventions on the caregiver burden, depression, and quality of life of informal caregivers of cancer patients.Methods A literature search was conducted in six electronic databases (PubMed, EMBASE, Web of Science, CENTRAL, PsycInfo, and CINAHL Plus with Full Text) from the inception of the databases to 31 May 2021. Two authors independently screened the studies and extracted the data. Cochrane's bias risk tool for randomized controlled trials was used to examine the methodological quality of the included studies. The intervention effect was estimated by calculating the standard mean difference (SMD) and 95% confidence interval (CI) with Review Manager 5.3. A sensitivity analysis was conducted to test the robustness of the pooled results.Results Seven randomized controlled trials with 326 participants were included in the review. The results of the meta-analysis showed that e-Health interventions could significantly improve the depression (SMD = -0.90, 95% CI [-1.76∼-0.04], P = 0.04) and quality of life (SMD = 0.45, 95% CI [0.13∼0.77], P = 0.006), but not caregiver burden (SMD = -0.29, 95% CI [-0.61∼0.02], P = 0.07) in informal caregivers. Sensitivity analysis showed that only the caregiver burden was stable.Conclusion e-Health interventions are a convenient method to support the informal caregivers of cancer patients, and can mitigate depression and enhance the quality of life of informal caregivers, but had no significant effect on easing the caregiver burden. In future, tailored e-Health intervention, based on informal caregivers' demographic characteristics and cultural context, is warranted to improve informal caregivers' well-being.Registration number CRD42021250253 (PROSPERO).
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Compared to care as usual, e-Health interventions effectively reduced symptoms of depression and improved quality of life of caregivers of cancer survivors.
“a recent systematic review [32] identified that, compared to care as usual, e-Health interventions effectively reduced symptoms of depression and improved quality of life of caregivers of cancer survivors.”
e-Health interventions did not significantly reduce caregiver burden.
“However, it is important to note that these interventions did not significantly reduce the caregiver burden26,27.”
From Anxiety, depression, and quality of life of caregivers of palliative care patients with cancer (2025) · cites this paper as [26]
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- Authors
- Li, Y., Li, J., Zhang, Y., Ding, Y., & Hu, X.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Hu, Xiaolin
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 127
- Pages
- 104179
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W4206107020
- Cited by
- 130
- References
- 51
- Citations by year
- 2026: 30 · 2025: 36 · 2024: 37 · 2023: 19 · 2022: 8
- FWCI
- 5.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sichuan University West China Hospital
- National Natural Science Foundation of China (82172842, 81803104)
- Sichuan University (2020HXBH119)
- Science and Technology Department of Sichuan Province (2022SYSX0064)
- National Key Research and Development Program of China (2021YFE0206600)
- Topics
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- digital health interventions, informal caregivers, caregiver burden, depression, quality of life, cancer patients, caregiver well-being
- MeSH terms
- Caregiver Burden, Depression, Humans, Neoplasms, Quality of Life, Randomized Controlled Trials as Topic, Caregivers, Telemedicine
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