Aims

Psychological interventions for people with cancer that are self-guided, rather than requiring facilitation, have advantages as they are potentially cost-effective and widely accessible. There is a need to identify whether self-guided psychological interventions can improve health outcomes for people with cancer.

Methods

Three electronic databases (Medline, PsycInfo and CINAHL) were searched. Articles were included if they were randomised controlled trials, published between January 2000 and June 2015, the intervention targeted adults diagnosed with cancer and was a psychological, self-guided (largely facilitated by the patient) intervention. Studies were excluded if the intervention was passive or educational, or was not a psychological intervention (e.g. exercise interventions). Included studies were assessed for quality and bias.

Results

A total of 1753 papers were identified and of these 17 studies met the inclusion criteria. Self-guided interventions were described as i) interactive materials (n=8), ii) online resources (n=6) or iii) brief resources (n=3). Papers were diverse in their content, delivery, population and settings. The majority of the studies (n=15) were underpowered. Compliance to and engagement with the interventions by participants was varied across studies. Patient reported outcomes were used as outcome measures across all studies. Despite aiming to be self-guided, all interventions required some facilitation, to ensure adherence, answer questions or troubleshoot. The majority of studies did not specifically target patients with psychological distress.

Conclusions

The review highlighted there was insufficient evidence for the implementation of self-guided psychological interventions for people with cancer. There is a need to generate evidence to understand the impact of psychological self-guided interventions, specifically: the ideal point in the disease and treatment trajectory, target patient groups, settings, content, optimal outcomes (including systems factors), and mode of delivery (online or interactive resource).  Cost-benefit analyses are also warranted to determine the potential impact on health service delivery.