Aims: To assess and synthesize the evidence of the effects and safety of non-pharmacological interventions in treating pain in patients with advanced cancer.
Background: Pain is a common symptom experienced by patients with advanced cancer; the treatment of such pain is often suboptimal. To manage it, non-pharmacological interventions are recommended after pharmacological treatments have been re-evaluated and modified. However, there remains a lack of knowledge about the effects and safety of such interventions.
Design: A systematic review was conducted based on the procedure of the Centre of Reviews and Dissemination.
Data sources: Research papers published between 2000-2013 were identified from the following databases: CINAHL, MEDIC, MEDLINE (Ovid) and PsycINFO. The references in the selected studies were searched manually.
Review methods: The studies selected were reviewed for quality, using Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria.
Results: There was limited evidence that some of the non-pharmacological interventions were promising with respect to reducing cancer pain. Relatively, few adverse events were reported as a result of using such interventions.
Conclusion: It was not possible to draw conclusions about the effects and safety of the non-pharmacological interventions in reducing cancer pain. Some interventions showed promising short-term effects, but there is a need for more rigorous trials. Qualitative studies are required to collect information about patients' perceptions. There are several research gaps: we found no studies about music, spiritual care, hypnosis, active coping training, cold or ultrasonic stimulation.
Keywords: adult care; cancer; complementary therapy; holistic care; literature review; non-pharmacological intervention; nursing; pain; palliative care.
© 2014 John Wiley & Sons Ltd.