Digital Health Supportive Care Interventions for Breast Cancer Survivors: An Umbrella Review of Systematic Reviews and Meta-Analyses
7 affiliations
- 1Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
- 2Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada
- 3Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
- 4Department of Biostatistics and Bioinformatics, Duke University, Durham, NC 27710, USA
- 5Research and Translational Innovation Office, SingHealth Community Hospitals, 10 Hospital Blvd, Singapore 168582, Singapore
- 6Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore
- 7Department of General Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
Abstract
Background/Objectives: Digital health interventions are a common form of supportive care for breast cancer survivors and may improve quality of life (QoL), physical activity and psychosocial outcomes, yet the evidence is fragmented across many systematic reviews. This umbrella review synthesised systematic reviews and meta-analyses of digital health interventions for breast cancer survivors to characterise their modalities, effectiveness and readiness for real-world implementation. Methods: Following a prospectively registered protocol (PROSPERO CRD420251185022), six databases were searched from inception to July 2025 for systematic reviews or meta-analyses evaluating any digital health intervention in adult breast cancer survivors and reporting QoL, physical or psychosocial outcomes. Methodological quality was appraised with AMSTAR-2, certainty of evidence with GRADE, overlap of primary studies with the corrected covered area (CCA), and findings were synthesised narratively. Results: Twenty-three systematic reviews were included, encompassing 459 primary study occurrences (333 unique studies; CCA 1.7%, slight overlap) and 44,560 participants across the 15 reviews that reported sample sizes. Interventions comprised online programmes, mobile applications (mHealth), telephone-based interventions, wearable activity trackers, virtual reality and an artificial intelligence chatbot. Across the included reviews, digital health interventions generally demonstrated favourable effects on QoL, physical activity, and psychosocial outcomes, although findings varied across intervention modalities and individual outcomes. Methodological confidence was low in 19 of 23 reviews (83%), limiting the robustness of these findings. Engagement or adherence was reported by 83% of reviews, but economic data (13%), equity considerations (35%) and health-system integration (43%) were rarely addressed. Conclusions: Digital health interventions show promise as supportive care tools for breast cancer survivors, particularly for improving QoL, physical activity, and psychosocial well-being. However, methodological limitations and evidence gaps regarding long-term engagement and cost-effectiveness persist. Future work should evaluate their integration into survivorship pathways, report engagement as standard, and generate the implementation and economic evidence that integration requires.
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BibTeX
@article{kon2026digital,
title = {{Digital Health Supportive Care Interventions for Breast Cancer Survivors: An Umbrella Review of Systematic Reviews and Meta-Analyses}},
author = {Mattias Wei Ren Kon and Joan Ern Xin Tan and Charmaine Su Min Tan and Rachel Qiao Jie Lim and Kevin Xiang Zhou and Nan Liu and Qin Xiang Ng and Serene Si Ning Goh},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213434},
url = {https://www.mdpi.com/2072-6694/18/21/3434},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Digital Health Supportive Care Interventions for Breast Cancer Survivors: An Umbrella Review of Systematic Reviews and Meta-Analyses
AU - Mattias Wei Ren Kon
AU - Joan Ern Xin Tan
AU - Charmaine Su Min Tan
AU - Rachel Qiao Jie Lim
AU - Kevin Xiang Zhou
AU - Nan Liu
AU - Qin Xiang Ng
AU - Serene Si Ning Goh
PY - 2026
DA - 2026/10/23
JO - Cancers
DO - 10.3390/cancers18213434
UR - https://www.mdpi.com/2072-6694/18/21/3434
AB - Background/Objectives: Digital health interventions are a common form of supportive care for breast cancer survivors and may improve quality of life (QoL), physical activity and psychosocial outcomes, yet the evidence is fragmented across many systematic reviews. This umbrella review synthesised systematic reviews and meta-analyses of digital health interventions for breast cancer survivors to characterise their modalities, effectiveness and readiness for real-world implementation. Methods: Following a prospectively registered protocol (PROSPERO CRD420251185022), six databases were searched from inception to July 2025 for systematic reviews or meta-analyses evaluating any digital health intervention in adult breast cancer survivors and reporting QoL, physical or psychosocial outcomes. Methodological quality was appraised with AMSTAR-2, certainty of evidence with GRADE, overlap of primary studies with the corrected covered area (CCA), and findings were synthesised narratively. Results: Twenty-three systematic reviews were included, encompassing 459 primary study occurrences (333 unique studies; CCA 1.7%, slight overlap) and 44,560 participants across the 15 reviews that reported sample sizes. Interventions comprised online programmes, mobile applications (mHealth), telephone-based interventions, wearable activity trackers, virtual reality and an artificial intelligence chatbot. Across the included reviews, digital health interventions generally demonstrated favourable effects on QoL, physical activity, and psychosocial outcomes, although findings varied across intervention modalities and individual outcomes. Methodological confidence was low in 19 of 23 reviews (83%), limiting the robustness of these findings. Engagement or adherence was reported by 83% of reviews, but economic data (13%), equity considerations (35%) and health-system integration (43%) were rarely addressed. Conclusions: Digital health interventions show promise as supportive care tools for breast cancer survivors, particularly for improving QoL, physical activity, and psychosocial well-being. However, methodological limitations and evidence gaps regarding long-term engagement and cost-effectiveness persist. Future work should evaluate their integration into survivorship pathways, report engagement as standard, and generate the implementation and economic evidence that integration requires.
SN - 2072-6694
ER -