Effect of patient education in improving quality of life, fatigue and anxiety in people diagnosed with lung cancer: systematic review

Abstract Purpose To assess the effect of patient education on quality of life, fatigue, and anxiety in patients diagnosed with lung cancer. Methods An electronic search was conducted across four databases (PubMed, Web of Science, CINAHL, and Scopus) using a combination of terms including lung neoplasms , health education , educat (truncated), quality of life , fatigue , and anxiety . The Cochrane RoB 2 tool and the TIDieR checklist were used to assess risk of bias and intervention replicability, respectively. The GRADE approach was applied to evaluate the certainty of the evidence. Study selection, data extraction, and all assessments were carried out independently by two reviewers. Where appropriate, data were pooled using meta-analysis (95% confidence interval [CI]). Results Seventeen studies were included in the qualitative synthesis, and thirteen in the quantitative analysis, comprising a total sample of 1799 participants. The meta-analysis demonstrated that, compared with controls, patient education interventions had a statistically significant and large effect on improving quality of life (SMD = 0.98; 95% CI [0.26, 1.69], p = 0.007, I 2 = 96%), anxiety (SMD = -1.75; 95% CI [-2.74, -0.77], p = 0.0005, I2 = 98%) and fatigue (SMD = -0.091; 95% CI [-1.61, -0.22], p = 0.01, I2 = 88%). In all cases, heterogeneity remained high. However, the educational content of the interventions was generally consistent, with most being delivered in a face-to-face format. Conclusions Patient education appears to be an effective approach for improving quality of life, fatigue, and anxiety in individuals with lung cancer. Nevertheless, these findings should be interpreted with caution, as the certainty of the evidence was rated as very low.