PMID- 28278559
OWN - NLM
STAT- MEDLINE
DCOM- 20170705
LR  - 20200225
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
VI  - 3
IP  - 3
DP  - 2017 Mar 10
TI  - Online support groups for women with breast cancer.
PG  - CD011652
LID - 10.1002/14651858.CD011652.pub2 [doi]
LID - CD011652
AB  - BACKGROUND: Survival rates for women with a diagnosis of breast cancer continue 
      to improve. However, some women may experience physical, psychological and 
      emotional effects post diagnosis, throughout treatment and beyond. Support groups 
      can provide opportunities for people to share their experiences and learn from 
      others. As the number of online support groups increases, more and more women 
      with breast cancer will likely access them. OBJECTIVES: To assess effects of 
      online support groups on the emotional distress, uncertainty, anxiety, depression 
      and quality of life (QoL) of women with breast cancer. SEARCH METHODS: We 
      searched for trials in the Cochrane Breast Cancer Specialised Register, the 
      Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4), MEDLINE, 
      Embase and PsycINFO on 2 May 2016, and we handsearched journals and reference 
      lists. We also searched the World Health Organization's International Clinical 
      Trials Registry Platform (WHO ICTRP) search portal and clinicaltrials.gov on 2 
      May 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) 
      assessing effects of online support groups on women with a diagnosis of breast 
      cancer and women who have completed breast cancer treatment. We included studies 
      comparing online support groups with a usual care group, and studies comparing 
      two or more types of online support groups (without a usual care group). DATA 
      COLLECTION AND ANALYSIS: Two review authors independently extracted data and 
      assessed risk of bias. We presented outcome data using mean differences (MDs) and 
      standardised mean differences (SMDs) along with 95% confidence intervals (CIs), 
      and we used the fixed-effect model when appropriate. We assessed the quality of 
      the body of evidence using the GRADE approach. MAIN RESULTS: We included six 
      studies (492 women) that assessed online support groups for women with breast 
      cancer. Online support groups in these six trials lasted from six to 30 weeks. 
      Women participated in these groups between 1.5 and 2.5 hours per week, and 
      investigators conducted all studies in the USA. Participants were predominantly 
      white and well educated and were moderate to high earners. Four studies compared 
      an online support group versus a control group, and the other two compared a 
      'moderated' versus a 'peer-led' online support group, and a 'standard' versus an 
      'enhanced' online support group, respectively.None of the included studies 
      measured 'emotional distress' or uncertainty. One study (78 women) for which data 
      for analysis were missing reported no positive effects of online support on 
      'distress' and 'cancer-specific distress' versus support provided by a control 
      group. Two studies measured anxiety: One study (72 women) found no difference in 
      anxiety at the end of the intervention between the online support group and the 
      control group (MD -0.40, 95% CI -6.42 to 5.62; low-quality evidence), and the 
      second study (184 women) reported a reduction in anxiety levels at the end of the 
      intervention when comparing the 'standard' support group (run by participants 
      without prompting from health professionals) versus an 'enhanced' online support 
      group (in which participants were specifically asked by the researcher to respond 
      to one another's need for support).Five studies (414 women) measured depression. 
      Three studies compared depression in the online support group with depression in 
      the control group. Pooled data from two studies (120 women) showed a small to 
      moderate reduction in depression in the online support group compared with 
      control groups at the end of the intervention (SMD -0.37, 95% CI -0.75 to 0.00; 
      very low-quality evidence). The third study, a pilot study (30 women), provided 
      no data for analysis but reported no difference in depression between 
      participants in support and control groups at the end of the intervention. Of the 
      remaining two studies that measured depression, one study (60 women) provided no 
      extractable data for comparison but reported no difference in depressive symptoms 
      between a 'moderated' and a 'peer-led' support group; the other study (184 women) 
      reported greater reduction in depression in the 'standard' support group than in 
      the 'enhanced' online support group.Three studies measured quality of life. One 
      pilot study (30 women) provided limited data for analysis but reported no change 
      in quality of life at the end of the intervention. Only two studies (140 women) 
      provided data for pooling and showed no positive effects on quality of life at 
      four months post intervention compared with controls (SMD -0.11, 95% CI -0.47 to 
      0.24; very low-quality evidence). At 12 months post intervention, one study (78 
      women) reported that the intervention group did not attain better quality of life 
      scores than the control group (MD -10.89, 95% CI -20.41 to -1.37; low-quality 
      evidence).We found no data for subgroup analyses on stage of disease, treatment 
      modality and types and doses of interventions. No studies measured adverse 
      effects. AUTHORS' CONCLUSIONS: This review did not find the evidence required to 
      show whether participation in online support groups was beneficial for women with 
      breast cancer, because identified trials were small and of low or very low 
      quality. Large, rigorous trials with ethnically and economically diverse 
      participants are needed to provide robust evidence regarding the psychosocial 
      outcomes selected for this review.
FAU - McCaughan, Eilis
AU  - McCaughan E
AD  - Institute of Nursing and Health Research, Ulster University, Coleraine, UK, BT52 
      1SA.
FAU - Parahoo, Kader
AU  - Parahoo K
AD  - Institute of Nursing and Health Research, Ulster University, Coleraine, UK, BT52 
      1SA.
FAU - Hueter, Irene
AU  - Hueter I
AD  - Statistics Department, Columbia University, 1255 Amsterdam Avenue, New York, NY, 
      USA, 10027.
FAU - Northouse, Laurel
AU  - Northouse L
AD  - School of Nursing, University of Michigan, 400 N.Ingalls, Ann Arbor, Michigan, 
      USA, 48105.
FAU - Bradbury, Ian
AU  - Bradbury I
AD  - Frontier Science Scotland, Kincraig, Scotland, UK.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20170310
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
SB  - IM
UOF - doi: 10.1002/14651858.CD011652
MH  - Anxiety/therapy
MH  - Breast Neoplasms/*psychology
MH  - Consumer Health Information/*statistics & numerical data
MH  - Depression/therapy
MH  - Female
MH  - Humans
MH  - Peer Group
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Self-Help Groups/*statistics & numerical data
MH  - Time Factors
PMC - PMC6464660
COIS- EM: nothing to declare.
 KP: nothing to declare.
 IH: nothing to declare.
 LN: 
      nothing to declare.
 IB: nothing to declare
EDAT- 2017/03/10 06:00
MHDA- 2017/07/06 06:00
PMCR- 2018/03/10
CRDT- 2017/03/10 06:00
PHST- 2017/03/10 06:00 [pubmed]
PHST- 2017/07/06 06:00 [medline]
PHST- 2017/03/10 06:00 [entrez]
PHST- 2018/03/10 00:00 [pmc-release]
AID - CD011652.pub2 [pii]
AID - 10.1002/14651858.CD011652.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2017 Mar 10;3(3):CD011652. doi: 
      10.1002/14651858.CD011652.pub2.