A systematic review of randomized controlled trials on telecommunication technologies for pain management in patients with advanced cancer: incorporating electronic patient-reported outcomes (ePROs)

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BACKGROUND: Pain is prevalent among cancer patients and impairs quality of life. Telemedicine, including electronic patient-reported outcomes (ePROs), is a promising tool for remote pain management. The objective of this review is to critically analyze studies on the use of telecommunication technologies for pain management in patients with advanced cancer receiving palliative care. METHODS: A systematic search was conducted in PubMed, the Cochrane Library, CINAHL, MEDLINE, Web of Science, and Scopus for literature published up to December 31, 2024. The eligibility criteria were defined based on the PICO framework: P (Population): adult patients with advanced cancer-related pain; I (Intervention): telecommunication technology interventions delivered by healthcare professionals to reduce cancer-related pain; C (Comparison): usual care; O (Outcome): change in pain levels. RESULTS: Ten studies met the predetermined eligibility criteria. Among these, eight studies demonstrated a statistically significant between-group effect of the interventions on pain reduction, while two of four studies reported time-series effects of telemedicine, although these effects were not significantly different from those observed in the control group. In the latter group, symptom self-reporting via an ePRO system was utilized, and the collected information was incorporated into pain management strategies. Among the eight studies demonstrating the effectiveness of ePRO-based pain management, five involved patients reporting their pain status to healthcare providers and receiving advice and education on pain management. Three of these studies incorporated real-time responses from healthcare providers. The duration of the interventions varied across studies: one study lasted 1 week, two studies lasted 4 weeks, one study lasted 8 weeks, and one study extended to 6 months. The frequency of intervention also varied: three studies employed daily interventions, one used twice-weekly interventions, and one study also used twice-weekly interventions. Interventions were delivered by healthcare professionals such as pharmacists, nurses, physical therapists, and researchers. CONCLUSIONS: A wide range of intervention durations, healthcare professionals, and methods utilizing telecommunication technologies for cancer pain management were identified. The use of ePRO systems by healthcare providers for patients with advanced cancer shows potential; however, a consensus on the optimal approach remains lacking, highlighting the need for further validation.

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