Patient and Caregiver Education to Support Self-Efficacy and Self-Management During Immunotherapy-An Integrative Review

BACKGROUND: Immune checkpoint inhibitors (ICI) have improved cancer treatment, but this treatment can lead to immune-related adverse events (irAEs). Effective patient and caregiver education is essential to better management of irAEs and improved treatment outcomes.

OBJECTIVE: This integrative review aimed to elucidate how patient education on ICI efficacy and toxicity management affects patients with cancer and their family caregivers' self-efficacy and self-management when dealing with irAEs.

METHODS: An integrative review was conducted. EMBASE, MEDLINE, CINAHL, PsycINFO, and Scopus were searched for original research articles. Studies on educational interventions related to ICI and how it affects self-efficacy and self-management of irAEs were included. Data were analyzed using thematic analysis.

RESULTS: Of 4182 references screened; seven studies were included. Three themes emerged: (a) Feasibility of various strategies in patient education, (b) The effect of patient education on self-efficacy, and (c) Determinants to improve self-management of irAEs.

CONCLUSION: While traditional patient education methods (oral and/or written information) remain valuable, integrating digital technologies is promising to enhance understanding of ICI. Patient education, especially when combined with follow-up, can improve health-related quality of life and self-efficacy. However, health literacy plays a critical role in treatment and management of irAEs, emphasizing the need for personalized education approaches.

TRIAL REGISTRATION: The protocol is registered with PROSPERO (No. CRD42024511513).