Journal of advanced nursing · 2026
Doing It All or Doing It Best: An Umbrella Review of the Effectiveness of Specialist Cancer Nurse-Led Care.
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Thamm Carla, Button Elise, Crichton Megan, Charalambous Andreas, Christina Juliana, Turner Murray R, Pun Joe Wing, Crawford-Williams Fiona, Cook Olivia, Mahony Jane, Patford Kerry, Doherty Natasha, Paterson Catherine, Chan Raymond J
Аннотация
AIMS: To investigate the effectiveness, including economic outcomes, of specialist cancer nurse-led interventions.
DESIGN: A systematic umbrella review, reported in accordance with PRISMA guidelines.
METHODS: Systematically conducted reviews reporting any effectiveness or cost-effectiveness outcomes published between January 2014 and June 2025 were included. Each review was screened and a quality assessment conducted by two authors. Results were narratively synthesised with specialist cancer nurse-led interventions categorised according to the Omaha System Intervention Scheme.
DATA SOURCES: CINAHL, Cochrane DSR, Medline, PsycINFO, PROSPERO and Google Scholar.
FINDINGS: 34 of 1389 reviews screened were included, reporting on 330 individual primary studies. Over 190,000 people with various types of cancer were represented. Cancer nurse-led interventions described in the reviews were delivered face-to-face, via telephone or internet and included (1) teaching, guiding and counselling; (2) treatments and procedures; (3) case management; and (4) surveillance interventions. Cancer nurse-led interventions were more effective compared to alternative care models at improving self-management and behaviour capabilities in 10/14 reviews (71%), symptom burden in 17/29 (58%) and patient satisfaction in 10/17 (59%). Nurse-led interventions demonstrated comparable effects on quality of life, survival, economic outcomes overall when compared to alternative care models. Limited full or partial economic evaluations were found. Usual care was not well described in the reviews, but in primary studies, over 80% of interventions were delivered as an addition to usual care rather than as an alternative to other healthcare professionals.
CONCLUSIONS: Nurses are effective at delivering care across the cancer trajectory but are most effective at self-management and behavioural support and symptom management. Robust full economic evaluations are needed to determine the value of cancer nurse-led interventions. Findings from this review can be used to guide policy and strategic planning on where specialist cancer nurses are best placed for maximum impact. No Patient or Public Contribution.
PROTOCOL REGISTRATION: A protocol was registered with PROSPERO (CRD42024559328), which included the methods for this umbrella review.
DESIGN: A systematic umbrella review, reported in accordance with PRISMA guidelines.
METHODS: Systematically conducted reviews reporting any effectiveness or cost-effectiveness outcomes published between January 2014 and June 2025 were included. Each review was screened and a quality assessment conducted by two authors. Results were narratively synthesised with specialist cancer nurse-led interventions categorised according to the Omaha System Intervention Scheme.
DATA SOURCES: CINAHL, Cochrane DSR, Medline, PsycINFO, PROSPERO and Google Scholar.
FINDINGS: 34 of 1389 reviews screened were included, reporting on 330 individual primary studies. Over 190,000 people with various types of cancer were represented. Cancer nurse-led interventions described in the reviews were delivered face-to-face, via telephone or internet and included (1) teaching, guiding and counselling; (2) treatments and procedures; (3) case management; and (4) surveillance interventions. Cancer nurse-led interventions were more effective compared to alternative care models at improving self-management and behaviour capabilities in 10/14 reviews (71%), symptom burden in 17/29 (58%) and patient satisfaction in 10/17 (59%). Nurse-led interventions demonstrated comparable effects on quality of life, survival, economic outcomes overall when compared to alternative care models. Limited full or partial economic evaluations were found. Usual care was not well described in the reviews, but in primary studies, over 80% of interventions were delivered as an addition to usual care rather than as an alternative to other healthcare professionals.
CONCLUSIONS: Nurses are effective at delivering care across the cancer trajectory but are most effective at self-management and behavioural support and symptom management. Robust full economic evaluations are needed to determine the value of cancer nurse-led interventions. Findings from this review can be used to guide policy and strategic planning on where specialist cancer nurses are best placed for maximum impact. No Patient or Public Contribution.
PROTOCOL REGISTRATION: A protocol was registered with PROSPERO (CRD42024559328), which included the methods for this umbrella review.