title: Sickle Cell Disease: A Review of Nonpharmacological Approaches for Pain.
abstract: BACKGROUND
  Sickle cell disease (SCD) is a life-threatening condition that affects more than seven million people worldwide. The most common complication experienced by persons living with SCD is pain. Evidence supports the use of nonpharmacologic therapies in managing psychological and social complications of pain in persons with SCD, but there is little consensus if these approaches can also be applied for the treatment of pain in SCD.
  
  
  OBJECTIVE
  To describe and synthesize the use of nonpharmacological therapies for reducing pain of any type and origin in persons with SCD.
  
  
  METHODS
  A literature search was conducted using PsycINFO, PsycARTICLES, PubMed, CINAHL, and Embase. Databases were searched using the following terms: sickle cell, pain, and nonpharmacological therapies. Interventions were graded for methodological quality and categorized as 1) peer-support group therapies, 2) educational/psychological therapies, and 3) skill-based therapies.
  
  
  RESULTS
  Twenty-eight nonpharmacological interventions for persons with SCD were examined. Of these studies, a wide variety of nonpharmacological interventions were tested. Twelve studies yielded significant improvements in pain, three studies reported no positive effect or differences between experimental and control conditions on pain or a pain-related outcome, and one study reported a negative or detrimental intervention effect.
  
  
  CONCLUSIONS
  Approximately half of the studies reviewed demonstrated success in alleviating pain, suggesting that patients are able to use nonpharmacological interventions to reduce pain with some degree of success. Questions still remain regarding the efficacy and generalizability of these interventions for persons with SCD.
authors.affiliation: School of Nursing, Duke University, Durham, North Carolina, USA. Electronic address: hantsawilliams@gmail.com.
authors.forename: Hants
authors.initials: H
authors.lastname: Williams
authors.affiliation: School of Nursing, Duke University, Durham, North Carolina, USA; School of Medicine, Duke University, Durham, North Carolina, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Tanabe
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy*; D059350:Chronic Pain / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods
keywords: Sickle cell disease; nonpharmacological; pain; pain management