Effects of acupressure on cancer-related pain management: A systematic review and meta-analysis of randomized controlled trials

Abstract

Acupressure is a non-invasive complementary treatment method that can positively affect the relief of cancer pain symptoms. The results from clinical trials have revealed that the effects of acupressure (including auricular acupressure) on cancer pain management are inconsistent. Our objective was to systematically evaluate the effect of acupressure on cancer pain. Seven databases (CNKI, VIP, Wanfang Database, SinoMed, Pubmed, Embase, and The Cochrane Library) were searched from their inception to November 2021 for randomized controlled trials (RCTs) of acupressure used for cancer pain. All analyses were conducted by RevMan5.3. The Cochrane RoB tool and GRADE were used to assess the risk bias and quality of evidence, respectively. Twenty-eight RCTs involving 2630 patients were included. Combined results showed the acupressure group had better outcomes in pain remission rate [RR 1.20, 95%CI (1.10, 1.30), P < 0.0001, I²= 61%], pain intensity [SMD -1.78, 95% CI, (-2.21, -1.35), P < 0.00001, I2= 94%], quality of life [SMD 0.62, 95%CI (0.35, 0.89), P<0.00001, I2=61%], patient satisfaction with analgesia [RR 1.14, 95%CI (1.05, 1.23), P = 0.001, I2=43%] compared with a control group. Two studies mentioned that acupressure as an adjunctive treatment could reduce the dose of analgesics. The bias of most studies was unclear because of irregular reporting according to the ROB tool, and meanwhile, most studies had high risk with no blinding. The GRADE evidence level was rated as moderate to very low. No studies measured adverse reactions. Acupressure (including auricular acupressure) group seemed to be more effective than the control group for cancer pain. However, the results were inconclusive due to weak evidence, and robust methodological RCTs with appropriate blinding are still needed to reconfirm the findings of our review. (osf.io/vyeum Registration DOI:10.17605/OSF.IO/VYEUM)