Effectiveness of non-pharmacological interventions for the treatment of headache in pediatric age. Overview of systematic reviews

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Rationale: headache, a common manifestation of pain in pediatric age, is often underestimated. The objective of study is to evaluate the efficacy of non-pharmacological interventions to reduce the symptoms. Methods and tools: overview of systematic reviews with interrogation of four biomedical databases (Cochrane Library, PubMed, Embase, CINAHL); quality evaluation of included documents with AMSTAR Checklist and effect size with NNT; narrative synthesis of results. Results: the included reviews show a benefit from interventions, substantially of psychological nature, with NNT = 2.32-4.98. Low quality evidence suggests caution on the estimates of effect. Discussion: the effectiveness depends on sex, age and how to evaluate the outcome. Conclusions: psychological interventions could be proposed as a potential alternative to pharmacotherapy.

Keywords: headache, non-pharmacological interventions, pediatric age.