title: The effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  This trial is registered with the ISRCT register, number ISRCTN87604299.
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. Electronic address: alex.molassiotis@manchester.ac.uk.
authors.forename: Alexander
authors.initials: A
authors.lastname: Molassiotis
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: Wanda
authors.initials: W
authors.lastname: Russell
authors.affiliation: Academic Palliative and Supportive Care Studies Group, Division of Primary Care, University of Liverpool, Liverpool, UK.
authors.forename: John
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Faculty of Health, University of Plymouth, Plymouth, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Breckons
authors.affiliation: Academic Palliative and Supportive Care Studies Group, Division of Primary Care, University of Liverpool, Liverpool, UK.
authors.forename: Mari
authors.initials: M
authors.lastname: Lloyd-Williams
authors.affiliation: Faculty of Health, University of Plymouth, Plymouth, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Richardson
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Hulme
authors.affiliation: Faculty of Health & Medicine, Lancaster University, Lancaster, UK.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Brearley
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Campbell
authors.affiliation: School of Health Sciences, University of Salford, Manchester, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Garrow
authors.affiliation: Clinical Trials Unit, Christie NHS Foundation Trust, Manchester, UK.
authors.forename: W David
authors.initials: WD
authors.lastname: Ryder
mesh_terms: D019050:Acupressure / Q000379:methods*; D015669:Acupuncture Points; D000293:Adolescent; D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000628:therapy*; D010349:Patient Compliance; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000628:therapy*; D014953:Wrist; D055815:Young Adult
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents
keywords: Acupressure; chemotherapy; nausea; vomiting