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Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Purpose

Different non-pharmacological interventions have been considered and applied to patients with colorectal cancer to improve their quality of life and distress symptoms; however, there is little evidence comparing the effectiveness of these strategies. This review aimed at assessing the effect of non-pharmacological interventions on quality of life, anxiety, and depression scores among patients with colorectal cancer.

Methods

A systematic search for articles published until August 1, 2020, in the English language was performed in Medline, EMBASE, Web of Science, and the Cochrane Library; the reference lists of eligible articles were scanned for other potentially eligible publications. A meta-analysis was performed using random-effects models to estimate pooled effect sizes.

Results

Twenty studies were included, representing a total of 3438 patients with colorectal cancer. Non-pharmacological interventions were associated with a significant reduction in anxiety (standardized mean difference [SMD] = − 0.157; 95% confidence interval [CI], − 0.312–[− 0.002]) and depression (SMD = − 0.207; 95% CI, − 0.390–[− 0.024]) scores during 5–8 months of follow-up. Subgroup analyses revealed that interventions delivered face-to-face improved patients’ quality of life during 1–4 months of follow-up. Moreover, interventions delivered face-to-face but without a behavioral component were associated with improved anxiety scores, whereas interventions with a behavioral component improved the depression scores during 5–8 months of follow-up.

Conclusions

Non-pharmacological interventions were associated with reduced anxiety and depression scores, whereas interventions delivered face-to-face were associated with improved quality of life scores in patients with colorectal cancer. Given the few studies and patients included in this meta-analysis, these conclusions should be interpreted with caution.

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

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This work was supported by the 1.3.5 Project for Disciplines of Excellence, West China Hospital of Sichuan University, and Sichuan University Training Program of Innovation and Entrepreneurship for Undergraduates (No. C2020107886).

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Authors and Affiliations

  1. West China School of Medicine, Sichuan University, Chengdu, China

    Xinyu Meng

  2. Gastrointestinal Surgery Center of West China Hospital, Sichuan University, Chengdu, China

    Xiaodong Wang

  3. Mental Health Center of West China Hospital, Sichuan University, Chengdu, China

    Zaiquan Dong

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All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by Xinyu Meng and Xiaodong Wang, who contributed equally to our work. The first draft of the manuscript was written by Xinyu Meng, Xiaodong Wang, and Zaiquan Dong, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Meng, X., Wang, X. & Dong, Z. Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 29, 5635–5652 (2021). https://doi.org/10.1007/s00520-021-06185-x

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