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Efficacy of Self-management Programs in Managing Side Effects of Breast Cancer

A Systematic Review and Meta-analysis of Randomized Control Trials

Boogaard, Lindsay, MSc(PT); Gater, Leah, MSc(PT); Mori, Mathieu, MSc(PT); Trincao, Andrew, MSc(PT); Smith-Turchyn, Jenna, MSc(PT)

doi: 10.1097/01.REO.0000475835.78984.41

Background: Self-management programs are interventions that support patient empowerment of independent health behaviors. As the number of individuals surviving cancer is increasing, these programs are becoming more popular in clinical settings. However, there is currently no systematic review that assesses the effectiveness of self-management programs, specifically for individuals with breast cancer.

Purpose: To determine the efficacy of self-management programs in decreasing treatment-related side effects experienced by breast cancer survivors at any point after their cancer diagnosis.

Methods: An electronic literature search was conducted within the CENTRAL (Cochrane Central Register for Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Ovid EMBASE, and MEDLINE online databases. Randomized controlled trials that included women who had a primary diagnosis of breast cancer, who had partaken in a self-management program, and whose outcomes were compared with women not participating in such programs were included in this review. Two reviewers independently screened and selected studies to be included and assessed risk of bias. A GRADE (Grading of Recommendations, Assessment Development and Evaluation) analysis was performed. Standard mean difference (SMD) and standard deviations were used to present the results of a meta-analysis of key outcomes.

Results: Nine trials were included in this review. Self-management interventions were found to significantly improve health-related quality of life, SMD (95% confidence interval [CI]) = 0.49 (0.16-0.82), P = .004; coping ability, SMD (95% CI) = 0.19 (0.03-0.34), P = .02; and fatigue, SMD (95% CI) = −0.94 (−1.69 to −0.18), P = .01.

Conclusions: Self-management programs were found to be effective in improving the health-related quality of life, coping abilities, and fatigue in individuals who have experienced treatment side effects of breast cancer. However, studies included in this review had poor methodological quality. Therefore, the results of this review should be viewed with caution.

School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada

Correspondence: Jenna Smith-Turchyn, MSc(PT), School of Rehabilitation Science, McMaster University, 1400 Main St West, Hamilton, ON L8S 1C7, Canada (

The authors declare no conflict of interest.

©2016 (C) Academy of Oncologic Physical Therapy, APTA
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