Effectiveness of telenursing for people with lung cancer at home: A systematic review and meta-analysis

Aim: To evaluate the effectiveness of telenursing involving nurses on the health outcomes of adults with lung cancer at home. Methods: We conducted literature searches on PubMed, CINAHL, EMBASE, CENTRAL, and the Japan Medical Abstracts Society up to December 2021. Articles eligible for inclusion were (i) reporting on randomized controlled trials involving telenursing, (ii) focusing on health consultations provided by healthcare providers involving nurses, and (iii) targeting adults with lung cancer at home. Two researchers independently screened eligible studies and assessed the risk of bias using the Cochrane risk-of-bias tool 2. We performed meta-analyses of symptom distress and quality of life. This study was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The quality of evidence was assessed applying the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Four studies with 508 participants were included, of which three were finally evaluated by meta-analysis. Telemonitoring and education by nursing professionals in collaboration with other healthcare professionals were confirmed. Symptom distress was significantly lower in the intervention group (mean difference = -0.54, 95% confidence interval: -1.06, -0.02). There was no significant effect on other outcomes. The GRADE assessment revealed serious risk of bias, inconsistency, and imprecision. Conclusions: The findings suggest that telenursing brought about low symptom distress in adults with lung cancer compared with the absence of telenursing. However, the certainty of the evidence was low owing to the high risk of bias. Further accumulation of high-quality studies is needed to establish definitive evidence.