Evaluating CAM treatment at the end of life: a review of clinical trials for massage and meditation.
BACKGROUND
There is a pressing need for improved end-of-life care. Use of complementary and alternative medicine (CAM) may improve the quality of care but few controlled trials have evaluated CAM at the end of life.


OBJECTIVE
To determine the strength of evidence for the benefits of touch and mind-body therapies in seriously ill patients.


METHODS
Systematic review of randomized controlled trials of massage and mind-body therapies. A PubMed search of English language articles was used to identify the relevant studies.


RESULTS
Of 27 clinical trials testing massage or mind-body interventions, 26 showed significant improvements in symptoms such as anxiety, emotional distress, comfort, nausea and pain. However, results were often inconsistent across studies and there were variations in methodology, so it was difficult to judge the clinical significance of the results.


CONCLUSIONS
Use of CAM at the end of life is warranted on a case-by-case basis. Limitations in study design and sample size of the trials analyzed mean that routine use of CAM cannot be supported. There are several challenges to be addressed in future research into the use of CAM in end-of-life patients.
Lafferty
William E
WE
University of Washington, School of Public Health and Community Medicine, Department of Health Services, Seattle, WA 98195, USA. billlaf@u.washington.edu
Downey
Lois
L
McCarty
Rachelle L
RL
Standish
Leanna J
LJ
Patrick
Donald L
DL
D000223:Adaptation, Psychological; D002986:Clinical Trials as Topic; D006801:Humans; D019018:Imagery, Psychotherapy; D008405:Massage; D019122:Meditation; D010146:Pain / Q000517:prevention & control; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care