Effectiveness of psychosocial interventions in improving the quality of life for adult patients with cancer in low- and middle-income countries (LMICs): a systematic review and meta-analysis

Several systematic reviews have been published on psychosocial care interventions (PCIs) in cancer care. However, there are limited systematic reviews and meta-analyses (SRMA) on the effectiveness of PCIs in cancer care for adults patients in low- and-middle income countries (LMICs). This study aimed at synthesizing the available evidence on the effectiveness of PCI in improving the quality of life (QoL) of adult cancer patients in LMICs. We registered the protocol with PROSPERO (ID: CRD4202342156) before conducting this SRMA. Studies published between 2002 and 2023 were searched from MEDLINE, Web of Science, EmBASE and APA PsycINFO. We followed the standard guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results of the pooled studies were analysed using MedCalc version 10.10 statistical software. Twenty-six intervention studies were included in this SRMA. The Eastern Mediterranean WHO region had the highest number of studies and Africa region had the least. Most studies utilised Cognitive Behavioural therapy-related interventions (38%, n = 10 studies), while Family systems therapy 4% (n = 1) was the least utilised. From the subgroup analyses of the means and standard deviations of domains of QoL in the pooled primary studies, the respective standardized mean differences indicated that the PCIs had a significant positive effect on the physical (0.972: p = 0.002), social (0.884: p = 0.005) and psychological (0.590: p = 0.03) domains of QoL of adult cancer patients. However, some PCIs did not improve the QoL of study participants. Generally, PCIs effectively improved most domains of the QoL of adult cancer patients. However, more research is needed for PCIs that had a negative effect on some domains of the QoL of cancer patients. Lastly, there is need for LMICs to prioritise resources to strengthen the integration of psychosocial care interventions in cancer care to meet the different QoL sub-domains of patients with cancer.