Molassiotis, A., Russell, W., Hughes, J., Breckons, M., Lloyd-Williams, M., Richardson, J., ... Ryder, W. (2013). The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: Assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technology Assessment,17(26), 1–114.

To determine the effectiveness of self-acupressure using wrist bands in the management of acute and delayed chemotherapy-induced nausea and vomiting (CINV) and to assess if the wrist bands are more effective in high, moderate, or low emetogenic chemotherapies

Patients were randomized using a method of minimization with a random element. Randomization was balanced for gender, age, and levels of emetogenic chemotherapy. Both patients and treating physicians were blinded to group. Patients received an acupressure wrist band, a sham acupressure wrist band, or no wrist band. All patients received the standard antiemetic regimen based on American Society of Clinical Oncology (ASCO) and Multinational Association of Supportive Care in Cancer (MASCC) guidelines with the exception of NK1-receptor antagonists, which were not available. The acupressure wrist bands are elastic with a 1 cm round plastic button. The button was worn at the P6 acupoint after patients were trained on the appropriate location to wear the button. The sham wrist bands had the button on the outside of the elastic band, and the button was worn facing away from the P6 point. Patients wore the wrist bands beginning the morning before chemotherapy and for six days after each cycle. Main outcome data were collected at baseline the day before chemotherapy and daily for up to seven days after chemotherapy, and additional data were collected on day 10. Some patients also participated in a qualitative interview.

• N = 361  
• AGE = Unable to determine
• MALES: 31.5%, FEMALES: 68.5%
• KEY DISEASE CHARACTERISTICS: Heterogeneous

• SITE: Multi-site    
• SETTING TYPE: Outpatient   
• LOCATION: United Kingdom

• PHASE OF CARE: Active antitumor treatment

Randomized, three-group, sham-controlled trial (Phase III)

• Rhodes Index of Nausea, Vomiting and Retching (INVR)
• MASCC Antiemesis Tool
• European Quality of Life-5 Dimensions (EQ-5D) utility scale
• Functional Assessment of Cancer Therapy—general quality of life scale
• Baseline measures—anxiety and depression, nausea/vomiting expectations, expectations from using the acupressure wrist bands

After the first cycle, there was no difference in the nausea level between any group, though there was a trend towards lower nausea scores for both the wrist band and sham wrist band groups. Qualitative interviews indicate that patients perceived both real and sham wrist bands as helpful in managing CINV.

Acupressure wrist bands are not an effective intervention in the management of CINV.

• Subject withdrawals ≥ 10%  
• Other limitations/explanation: 500 patients were randomized and data were only used on 361.

Nurses can educate patients that acupressure wrist bands are not an effective intervention to manage CINV.