Effect of Nonpharmacological Methods on Pruritus in Patients with Liver Disease and Liver Cirrhosis: Systematic Review.

BACKGROUND: Pruritus is a symptom that greatly affects the quality of life in patients with liver disease and liver cirrhosis. Since most pharmacological methods for itching have limited efficacy, there is a need to assess the effectiveness of nonpharmacological methods.

PURPOSE: This systematic review aims to examine the effects of nonpharmacological methods on itching in individuals with liver disease and liver cirrhosis.

METHODS: PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) criteria were used as the basis for creating the systematic review protocol and writing the article. Studies were searched in "Scopus, Web of Science, PubMed, Cochrane Library, and CINAHL" databases, and studies from January 1, 2016, to January 1, 2024, were included in this systematic review. Studies were selected based on inclusion and exclusion criteria according to the PICOS method, and these studies included in the review were evaluated using the revised Joanna Briggs Institute (JBI) critical evaluation lists according to their types.

RESULTS: Five randomized controlled trials with a total of 257 participants were included in this systematic review. While one of the studies was published in 2016, the others were published after 2016. The nonpharmacological interventions used in the studies consisted of baby oil, peppermint oil, clove oil, curcumin capsules, and ultraviolet light. In all five studies included in the review, it was found that nonpharmacological methods significantly reduced itching, with advantages such as being non-invasive, easy application, cheap, and very low toxicity and side effects.

CONCLUSIONS: Based on the findings, nonpharmacological methods have a positive effect on itching in individuals with liver disease and liver cirrhosis. It is recommended to conduct more studies with higher methodological quality, using larger sample groups, different interventions, randomization, and blinding methods, to examine the effectiveness of nonpharmacological methods in patients with liver disease and liver cirrhosis.