Interactive technologies and videotapes for patient education in cancer care: systematic review and meta-analysis of randomised trials

Abstract

Goals of work: Patients diagnosed with cancer need education as they face complex decisions. There is limited evidence about the impact of new educational technologies for cancer patients. This paper investigates whether interactive technologies and videotapes for patient education in cancer care improve knowledge, satisfaction or other outcomes.

Methods: Literature search of five computerised databases (Medical Literature Analysis and Retrieval System, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Controlled Trials Register and Cochrane Database of Systematic Reviews) and bibliography searches identified relevant randomized controlled trials. Two reviewers independently assessed trial quality. Summary effects for knowledge and satisfaction were calculated using random-effects models (RevMan 4.2 software). Continuous data were summarised as weighted mean differences and dichotomous data as odds ratios, each with their respective 95% confidence interval. Standardised effect sizes for these outcomes were calculated and contrasted.

Results: Nine randomised control trials with 1,678 patients were identified. Three evaluated the use of videotapes, and six evaluated computer technologies. Studies were of good-quality design but were variable in instruments, content, populations, outcomes and results. Educational technologies showed improved patient knowledge (effect sizes ranging from 0.12 to 1.03). Satisfaction was improved in some studies, but the overall effect was more equivocal--effect sizes ranged (0.05 to 0.40) of benefit for knowledge and from 0 to 0.40 for satisfaction.

Conclusions: The trials present preliminary evaluations of the technology in North America, the UK and Australia. There is a trend to improved knowledge and satisfaction. The ways in which the interventions are delivered and the extent of communication with a health professional affect patient responses.