Making Sense of Research by Menard Martha Brown

Author:Menard, Martha Brown
Language: eng
Format: epub
Publisher: Curties-Overzet Publications Inc.
Published: 2015-11-13T00:00:00+00:00

Study Example #2: Massage and Acupuncture for Postoperative Symptom Management

Symptom Management with Massage and Acupuncture in Postoperative Cancer Patients: A Randomized Controlled Trial

Wolf E. Mehling, MD, Bradly Jacobs, MD, MPH, Michael Acree, PhD, Leslie Wilson, PhD, Alan Bostrom, PhD, Jeremy West, BA, Joseph Acquah, OMD, Beverly Burns, OMD, Jnani Chapman, RN, CMP, and Frederick M. Hecht, MD Osher Center for Integrative Medicine (W.E.M., B.J., M.A., L.W., J.W., J.A., B.B., J.C., F.M.H.), and Department of Epidemiology and Biostatistics (A.B.), University of California, San Francisco, California, USA

Journal of Pain and Symptom Management Vol. 33 No. 3 March 2007 © 2007 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Abstract

The level of evidence for the use of acupuncture and massage for the management of perioperative symptoms in cancer patients is encouraging but inconclusive. We conducted a randomized, controlled trial assessing the effect of massage and acupuncture added to usual care vs. usual care alone in postoperative cancer patients. Cancer patients undergoing surgery were randomly assigned to receive either massage and acupuncture on postoperative Days 1 and 2 in addition to usual care, or usual care alone, and were followed over three days. Patients’ pain, nausea, vomiting, and mood were assessed at four time points. Data on health care utilization were collected. Analyses were done by mixed-effects regression analyses for repeated measures. One hundred fifty of 180 consecutively approached cancer patients were eligible and consented before surgery. Twelve patients rescheduled or declined after surgery, and 138 patients were randomly assigned in a 2:1 scheme to receive massage and acupuncture (n = 93) or to receive usual care only (n = 45). Participants in the intervention group experienced a decrease of 1.4 points on a 0-10 pain scale, compared to 0.6 in the control group (P = 0.038), and a decrease in depressive mood4 of 0.4 (on a scale of 1-5) compared to ± 0 in the control group (P = 0.003). Providing massage and acupuncture in addition to usual care resulted in decreased pain and depressive mood among postoperative cancer patients when compared with usual care alone. These findings merit independent confirmation using larger sample sizes and attention control. J Pain Symptom Manage 2007;33:258-266.

Funding for this study was provided by the Mount Zion Health Fund, San Francisco, California. The authors confirm that this material is original research and has not been published otherwise, with the exception of a presentation at the 2005 Bay Area Research Symposium, San Francisco, October 2005 and a poster presentation at the North American Research Conference on Complementary and Integrative Medicine, May 2006, Edmonton, Alberta, Canada.

Address reprint requests to: Wolf E. Mehling, MD, Osher Center for Integrative Medicine, University of California, San Francisco, 1701 Divisadero St., Suite 150, San Francisco, CA 94115, USA. E-mail: [email protected]

Accepted for publication: September 4, 2006.

Keywords

Cancer, surgery, symptom management, cancer pain, acupuncture, massage

Introduction

More than 40% of people with cancer report using complementary and alternative medicine (CAM) therapies.1 Leading cancer centers in the United States offer massage and acupuncture to inpatients and outpatients. A

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