Acupuncture as a tool to reduce nausea in terminally ill patients

Abstract

Aim: To investigate if acupuncture reduces nausea and vomiting in terminally ill patients.

Design: A comparative effectiveness research design was used to generate evidence-based knowledge close to practice for the use of clinicians. The sample size was calculated to 136 patients randomised into an intervention and a control group, respectively. Nausea and vomiting were measured using the EORTC QLQ-c15-PAL (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire, core 15, Palliation).

Location: The trial was conducted among terminally ill patients admitted to three in-bed hospices in Demark.

Participants: Terminally ill patients suffering from nausea and/or vomiting; 95% of patients had cancer.

Intervention: The intervention group received acupuncture in addition to usual care for three days. We used the acupuncture spots: Pericardium-6, Stomach-36, Liver-3 and Yin Tang. The control group received usual care only.

Results: In total, 136 patients were randomised, 24 patients withdrew resulting in a total sample of 112 patients: 52 patients in the intervention group and 60 patients in the control group. In the intervention group, 75% of the patients experienced a reduction of their nausea score after the intervention compared to 55% in the control group. The statistical difference was p = 0.028. In the intervention group, 52% of the patients did not experience nausea at all after the intervention compared to 30% in the control group. In the intervention group, 31% of the patients were still vomiting after the intervention compared to 34% in the control group; no statistically significant difference was found.

Conclusion: Acupuncture reduced the experience of nausea among terminally ill patients but did not reduce vomiting. Thus, acupuncture is recommended to reduce nausea among terminally ill patients.

Keywords: Liver-3; Pericardium-6; Stomach-36; Yin Tang; acupuncture; comparative effectiveness research; hospice; nausea; palliative care; terminal ill; vomiting.