• Alexander Molassiotis, Wanda Russell, John Hughes, Matthew Breckons, Mari Lloyd-Williams, Janet Richardson, Claire Hulme, Sarah G Brearley, Malcolm Campbell, Adam Garrow, and W David Ryder.
• School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. Electronic address: alex.molassiotis@manchester.ac.uk.
• J Pain Symptom Manage. 2014 Jan 1;47(1):12-25.

ContextBoth 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.ObjectivesTo clarify whether acupressure is effective in the management of chemotherapy-related nausea and vomiting.MethodsA 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.ResultsFive 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.ConclusionNo 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 RegistrationThis trial is registered with the ISRCT register, number ISRCTN87604299.Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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