Background: Various political, professional, consumer advocacy and policy drivers have led to significant financial investment in specialist cancer nursing roles to overcome unmet patient needs in navigation, coordination of care, informational support, self-management, while delivering a wide range of cancer treatments. Globally, no comprehensive evidence systematic review has evaluated the effectiveness and economic impact of specialist cancer nursing roles.
Aims: To understand the effectiveness and economic implications (costs and cost effectiveness) of specialist cancer nurse-led interventions and models of care?
Methods: An umbrella systematic review was reported in accordance with PRISMA guidelines. A comprehensive search was conducted in CINAHL, Cochrane DSR, Medline, PsycINFO, PROSPERO and Google Scholar for all systematic reviews published between January 2014 to June 2024. Data were screened, extracted and appraised by two authors. Results were narratively synthesised, and a quality assessment was conducted.
Conclusions: Of 1,192 reviews screened, 30 were included (encompassing 323 primary studies) across 16 countries in Europe (n= 13), Asia (n= 12), Australasia (n= 4), and North America (n= 2). A total of 191, 257 people with cancer across the entire cancer trajectory were represented in this review, including breast, colorectal/colon, endometrial/gynaecological, head and neck, prostate, gastric, lung, oesophageal, leukemia, lymphoma, urinary, and thyroid. Specialist cancer nurse-led interventions included: a) supported self-management by patient teaching, guidance or counselling, b) treatment delivery, c) case management, and d) surveillance - delivered face-to-face, via telephone, or internet. Evidence has identified that specialist cancer nurse-led interventions reduced symptom burden and improved self-management outcomes among patients compared to standard/usual care. Satisfaction outcomes were also higher for nurse-led interventions over standard/usual care. No differences were reported for quality of life, survival, healthcare utilisation, and cost outcomes between nurse-led interventions and standard/usual care. Findings from this review can inform future specialist nursing roles and models of cancer care.