The effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: a randomized controlled trial.
Author: Molassiotis A1, Russell W2, Hughes J3, Breckons M4, Lloyd-Williams M3, Richardson J4, Hulme C5, Brearley SG6, Campbell M2, Garrow A7, Ryder WD8.
Affiliation:
1School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. Electronic address: alex.molassiotis@manchester.ac.uk. 2School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. 3Academic Palliative and Supportive Care Studies Group, Division of Primary Care, University of Liverpool, Liverpool, UK. 4Faculty of Health, University of Plymouth, Plymouth, UK. 5Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. 6Faculty of Health & Medicine, Lancaster University, Lancaster, UK. 7School of Health Sciences, University of Salford, Manchester, UK. 8Clinical Trials Unit, Christie NHS Foundation Trust, Manchester, UK.
Conference/Journal: J Pain Symptom Manage.
Date published: 2014 Jan
Other:
Volume ID: 47 , Issue ID: 1 , Pages: 12-25 , Special Notes: doi: 10.1016/j.jpainsymman.2013.03.007. Epub 2013 Apr 17. , Word Count: 284
CONTEXT: Both positive and negative results have been reported in the literature from the use of acupressure at the P6 point, providing evidence of highly suggestive but not conclusive results.
OBJECTIVES: To clarify whether acupressure is effective in the management of chemotherapy-related nausea and vomiting.
METHODS: A randomized, three-group, sham-controlled trial was designed. Patients with cancer receiving chemotherapy were randomized to receive standardized antiemetics and acupressure wristbands, sham acupressure wristbands, or antiemetics alone. Primary outcome assessment (nausea) was carried out daily for seven days per chemotherapy cycle over four cycles. Secondary outcomes included vomiting, psychological distress, and quality of life.
RESULTS: Five hundred patients were randomized. Primary outcome analysis (nausea in Cycle 1) revealed no statistically significant differences between the three groups, although nausea levels in the proportion of patients using wristbands (both real and sham) were somewhat lower than those in the proportion of patients using antiemetics-only group. Adjusting for gender, age, and emetic risk of chemotherapy, the odds ratio of lower nausea experience was 1.18 and 1.42 for the acupressure and sham acupressure groups, respectively. A gender interaction effect was evident (P = 0.002). No significant differences were detected in relation to vomiting, anxiety, and quality-of-life measures.
CONCLUSION: No clear recommendations can be made about the use of acupressure wristbands in the management of chemotherapy-related nausea and vomiting as results did not reach statistical significance. However, the study provided evidence of encouraging signals in relation to improved nausea experience and warrants further consideration in both practice and further clinical trials.
TRIAL REGISTRATION: This trial is registered with the ISRCT register, number ISRCTN87604299.
Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
KEYWORDS: Acupressure; chemotherapy; nausea; vomiting
PMID: 23602325 [PubMed - indexed for MEDLINE]
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