Abstract

Migraine is a common and debilitating neurological condition. The limitations of drug-based preventive measures, such as insufficient effectiveness and poor tolerability, highlight the necessity for alternative prevention methods. This systematic review and meta-analysis examined the safety and efficacy of non-drug interventions aimed at preventing migraines in adults. Following PRISMA guidelines, this review conducted a comprehensive search of various databases from their inception until 2025 to identify relevant randomized controlled trials (RCTs), quasi-RCTs, and observational studies. Key outcomes measured were migraine frequency, intensity, disability levels, quality of life indicators, and medication usage. A total of ten studies were included indicating a non-significant decrease in the number of migraine days (mean difference [MD] = -1.06 per month; 95% confidence interval [CI]: -2.41 to 0.29) and pain intensity (MD = -1.40; 95% CI: -3.51 to 0.71), both exhibiting considerable heterogeneity (I² = 99%). Conversely, there was a statistically significant reduction in acute medication usage (MD = 0.29; 95% CI: 0.10 to 0.49; P = 0.003) with negligible heterogeneity (I² = 0%). A non-significant trend suggested that non-pharmacological interventions might favorably impact achieving a ≥50% reduction in headache frequency (odds ratio [OR] = 1.77; 95% CI: 0.77 to 4.10). Importantly, these interventions were well-tolerated without a significant increase in adverse events compared to control groups. Non-drug interventions are generally well-accepted by patients and show clear advantages in decreasing dependence on acute medications. However, their impact on lowering migraine frequency and pain intensity remains uncertain due to high variability and inconclusive pooled estimates.

Key words: Non-pharmacological interventions, prevention, migraine, adults, systematic review.