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: 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. Randomized controlled (RCTs) trials and quasi-experimental designed
(QED) studies that investigated non-pharmacological interventions for
pediatric patients with SCD until the age of 21 years were considered
for inclusion.
Results: Ten articles (5 RCTs and 5 QED studies) with 422
participants were included. They investigated cognitive behavioral
therapy (CBT) (n =5), biofeedback (n=2), massage (n=1), virtual reality
(n=1) and yoga (n=1). CBT, biofeedback, massage, virtual reality and
yoga significantly reduced frequency and/or intensity of SCD-related
pain. Biofeedback also significantly reduced analgesic use.
Conclusion: Non-pharmacological interventions may be effective
in reducing pain in pediatric SCD patients. 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 to improve the outcome of
sickle cell-related pain.