A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Implications and recommendations for developing an online self-help program

Aims: While metastatic breast cancer (MBC) is incurable, many women live with the disease for a long time, with a median survival time of 2–4 years. A diagnosis of MBC brings significant adjustment challenges for women, and psychological morbidity rates typically range from 35–43%. Despite this, there is little data on how best to address these. A review conducted up until 2011 found only 10 intervention studies, largely delivered in a group format. This presentation aims to update the evidence-base for psychological interventions for women with MBC, and discuss how these can inform the development of an online self-help program.
Methods: Four electronic bibliographic databases were searched: MEDLINE (OvidSP), PsychINFO (OvidSP), CINAHL (EBSCO), and SCOPUS; and reference lists of previous trials, systematic reviews and metaanalyses were examined. Selection criteria included: (a) Randomised controlled trial, (b) metastatic breast cancer, (c) psychotherapeutic intervention, and (d) outcomes related to either survival or psychosocial adjustment (distress, quality of life, sleep, fatigue, pain, social support).
Results: Initial database searches yielded 1063 results. After removing duplicates, titles and abstracts of 706 records were screened for possible inclusion against the eligibility criteria by two review authors independently,
resulting in 29 full-texts being retrieved for further assessment. Of the full-texts retrieved for full-screening, 21 were therapist-administered (TA) group-interventions, 3 were TA individual-interventions, and 5 were low-intensity interventions (i.e., self-help / telephone / internet). Data was extracted and the study quality assessed using the Cochrane Collaboration risk of bias tool. Study characteristics, methodological quality, efficacy and survival outcomes will be discussed.
Conclusions: There remains a paucity of psychological interventions developed specifically for women with MBC, and novel delivery formats are warranted. The current findings will help to inform the development of an online self-help program for this population.