The effect of non-pharmacological supportive care interventions on patient-reported outcomes among patients with a brain tumour: A systematic review and meta-analysis

Purpose: Brain tumours are associated with significant disease burden with needs fluctuating throughout the disease trajectory. The aim of this systematic review and meta-analysis was to assess the effect of non-pharmacological supportive care interventions on patients with a primary brain tumour by means of patient-reported outcome measures. Methods: The following electronic databases were systematically searched: Academic Search Complete, APA PsycInfo, APA PsycArticles, CINAHL Plus, Cochrane, PubMed, and Web of Science. Additional records were located from Google Scholar, reference tracking, and hand searching. Title, abstract, and full-text screenings were completed by two independent reviewers. Data were extracted using a standardised extraction table. Quality appraisal was conducted using the Mixed Method Appraisal Tool. Results were described via narrative synthesis or meta-analyses of standardised scores for randomised controlled trials. Results: From 1261 records, nine studies were included. Various interventions were utilised including five exercise-based interventions (aerobics, Pilates, yoga, in-patient rehabilitation and out-patient rehabilitation), two cognitive rehabilitation programs, and two psychosocial interventions. Eight of the nine interventions benefitted patients with statistically significant improvement to at least one aspect of their wellbeing. Meta-analyses of randomised controlled trials for all interventions found standardised mean improvements to the outcomes of quality of life (0.34, p-value = 0.037), psychological wellbeing (0.35, p-value = 0.001), cognitive symptoms (0.41, p-value = 0.016), and fatigue (0.31, p-value <0.001). Conclusion: Non-pharmacological supportive care interventions showed positive effects in reducing symptom burden among patients with primary brain tumours. Further research with larger sample sizes is needed to confirm these findings.