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Efficacy of non-pharmacological interventions to reduce pain in children with sickle cell disease: A systematic review.

Pediatric blood & cancer
June 1, 2023
Sarah van Veelen et al. (7 authors)
Systematic ReviewJournal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the efficacy of non-pharmacological interventions, including massage, in reducing sickle cell-related pain in children with SCD.

Results Summary

The study included one article on massage, but specific results for massage were not detailed in the abstract. The overall conclusion suggested that non-pharmacological interventions, including massage, may be effective in reducing pain in pediatric SCD patients.

Population

Children with sickle cell disease (SCD) up to age 21.

Effective Dosage

Not available

Duration

Not available

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
cognitive behavioural therapy (CBT)
decrease
frequency and/or intensity of SCD-related pain
children with SCD
-
significantly reduced
#1
biofeedback
decrease
frequency and/or intensity of SCD-related pain
children with SCD
-
significantly reduced
#2
virtual reality
decrease
pain
children with SCD
-
significantly reduced
#3
yoga
decrease
pain
children with SCD
-
significantly reduced
#4
biofeedback
decrease
analgesic use
children with SCD
-
significantly reduced
#5
non-pharmacological interventions
no change
health service use
children with SCD
-
no effect
#6
Abstract

BACKGROUND: Pain is the clinical hallmark of sickle cell disease (SCD) leading to hospitalization, psychological sequelae and a decreased health-related quality of life. The aim of this systematic literature review is to evaluate the efficacy of non-pharmacological interventions in reducing sickle cell related pain in children with SCD. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search up until October 2022 was performed to identify studies that investigated the efficacy of non-pharmacological interventions on (1) pain frequency and/or intensity, and (2) analgesic and health service use in children with SCD until the age of 21. Both randomized controlled trials (RCTs) and quasi-experimental designed (QED) studies were considered for inclusion. RESULTS: Ten articles (five RCTs and five QED studies) with 422 participants were included. They investigated cognitive behavioural therapy (CBT) (n = 5), biofeedback (n = 2), massage (n = 1), virtual reality (n = 1) and yoga (n = 1). The majority of the interventions were psychological (n = 7) and were performed in the outpatient clinic (n = 6). CBT and biofeedback significantly reduced frequency and/or intensity of SCD-related pain in outpatient settings, while virtual reality and yoga significantly reduced pain in inpatient settings. Biofeedback also significantly reduced analgesic use. None of the included articles reported reduced health service use. CONCLUSION: Non-pharmacological interventions may be effective in reducing pain in paediatric patients with SCD. However, due to the heterogeneity of the included studies a quantitative analysis could not be performed. Awaiting further supporting evidence, healthcare providers should consider implementing these interventions as valuable part of a comprehensive pain management strategy plan.

Medical Subject Headings (MeSH)
ChildHumansPain ManagementPainAnalgesicsAnemia, Sickle CellCognitive Behavioral Therapy
Study Links
Quality Scores
SafetyNot Assessed
Efficacy60/10
Quality70/10
Citation Metrics
Total Citations6
Citations/Year3.0
Relative Citation Ratio2.07
NIH Percentile75.6%
Research Impact Scores
APT Score0.75
Weight Score2.51
Normalized Score0.58
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