Jones, E., Isom, S., Kemper, K.J., & McLean, T.W. (2008). Acupressure for chemotherapy-associated nausea and vomiting in children. Journal of the Society for Integrative Oncology, 6, 141–145.

To assess the feasibility, safety, and effectiveness of acupressure therapy for preventing or reducing chemotherapy-induced nausea and vomiting (CINV) in children receiving chemotherapy

• Patients were randomized to one of two acupressure treatment groups.
  • In group 1, patients wore acupressure wrist bands during first chemotherapy course, no wrist bands during second chemotherapy course, and placebo wrist bands during the third chemotherapy course.
  • In group 2, patients wore placebo wrist bands during first chemotherapy course, no wrist bands during second chemotherapy course, and true acupressure wrist bands during the third chemotherapy course.
• Patients received standard antiemetic therapy as directed by their physician.
• Patients completed questionnaires before and after each chemotherapy course.

• The study consisted of 18 participants.
• The age range was 5–19 years.
• In group 1, the mean age was 11.7 years (SD ± 4.2). In group 2, the mean age was 12.5 years (SD ±3.6).
• The sample was 50% female and 50% male.
• Cancer diagnoses were acute lymphoblastic leukemia, rhabdomyosarcoma, Ewing sarcoma, medulloblastoma, osteosarcoma, and other diagnoses (not specified).
• The majority of patients (n = 14) were Caucasian, 8 were enrolled in their first chemotherapy course, and 10 were enrolled in their second or later chemotherapy course.
• No patient had used acupressure or acupuncture prior to the study.

The study was conducted in a single inpatient site at a children’s hospital in North Carolina.

All participants were pediatric patients in active treatment.

This was a pilot study. It was a prospective, randomized, crossover clinical trial.

The study used modified methods of Morrow questionnaires. It did not state how the tool was modified. No reliability or validity information was provided.

Questionnaires quantified nausea on an 11-point Likert scale, collected demographics and diagnoses, and measured the following.

• Previous knowledge and experience with acupressure or acupuncture
• Expectations of nausea prevention
• Episodes of emesis
• Presence and degree of nausea
• Side effects
• Satisfaction
• Perceived differences between the acupressure and placebo bands

• Patients somewhat expected the bands to prevent nausea and vomiting. The mean rating of acupressure bands was 6.9 out of 10 and of placebo bands was 5.0 out of 10.
• No difference was found in nausea or number of vomiting episodes among the acupressure band, placebo band, and no band.
• After the bands were worn, many patients reported that their expectations of nausea prevention were met (56% if patients using the acupressure band and 67% of patients using the placebo band) or exceeded (33% of patients using the acupressure band and 28% of patients using the placebo band).
• When no bands were worn, 61% of patients expected more nausea.

Although acupressure bands did not show a reduction in nausea or vomiting, patients perceived the bands as moderately effective, planned to use them in the future, and indicated they would recommend them.

• The sample was small.
• The study did not consider other nausea and vomiting therapy such as antiemetic usage.
• Actual adherence to the wristbands was not reported.
• The reliability of questionnaire use with young children is not clear.

The acupressure bands did not demonstrate a significant change in actual incidence of nausea and vomiting; however, this therapy may be helpful in reducing expectations of CINV.