Alexander Molassiotis1, Wanda Russell2, John Hughes3, Matthew Breckons4, Mari Lloyd-Williams3, Janet Richardson4, Claire Hulme5, Sarah G Brearley6, Malcolm Campbell2, Adam Garrow7, W David Ryder8. 1. School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. Electronic address: alex.molassiotis@manchester.ac.uk. 2. School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. 3. Academic Palliative and Supportive Care Studies Group, Division of Primary Care, University of Liverpool, Liverpool, UK. 4. Faculty of Health, University of Plymouth, Plymouth, UK. 5. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. 6. Faculty of Health & Medicine, Lancaster University, Lancaster, UK. 7. School of Health Sciences, University of Salford, Manchester, UK. 8. Clinical Trials Unit, Christie NHS Foundation Trust, Manchester, UK.
Abstract
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.
RCT Entities:
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.
Authors: L Lee Dupuis; Kara M Kelly; Jeffrey P Krischer; Anne-Marie Langevin; Roy N Tamura; Ping Xu; Lu Chen; E Anders Kolb; Nicole J Ullrich; Olle Jane Z Sahler; Eleanor Hendershot; Ann Stratton; Lillian Sung; Thomas W McLean Journal: Cancer Date: 2017-12-19 Impact factor: 6.860
Authors: Jing-Yu Tan; Alexander Molassiotis; Tao Wang; Lorna K P Suen Journal: Evid Based Complement Alternat Med Date: 2014-11-25 Impact factor: 2.629