The efficacy of acupressure bands in reducing radiation therapy-induced nausea is enhanced when combined with expectancy enhancing information

Abstract

8158 Background: Mounting evidence suggests that patients’ expectancies relating to nausea development are significant predictors of, and likely, contributing factors to treatment-related nausea. Expectancy is also theorized to be the primary factor accounting for efficacy of alternative therapies such as acupressure bands. Methods: Patients with nausea from radiation therapy were randomized to either standard care (Arm 1), standard care plus acupressure bands plus a handout conveying information not intended to enhance efficacy expectations (Arm 2), or standard care plus acupressure bands plus information designed to enhance efficacy expectations (Arm 3). Prior to randomization, patients reported nausea (on a 7-point semantic rating scale, 1 = “not nauseated” to 7 = “extremely nauseated”) during four time periods (evening and night on the day of treatment, and morning and afternoon of the following day). The four nausea reports were then averaged to create a single score. Post-intervention nausea was assessed in a similar fashion. Results: 63 Patients (female = 37, mean age = 53.3 years) provided evaluable data. The 15 patients randomized to Arm 1 had a small (8%) increase in average nausea. The 26 patients randomized to Arm 2, by contrast, had a modest (15%) decrease in average nausea. A much larger (23%) reduction of nausea occurred in the 22 patients randomized to Arm 3. We used analysis of covariance, controlling for gender, to examine the nausea change scores (post intervention nausea minus baseline nausea) among treatment arms. The overall group difference closely approached conventional levels of statistical significance, P < .08, and the linear contrast was statistically significant, P < .03. Estimated marginal means of the change score for the three groups were: Arm 1 = 0.21, Arm 2 = -0.38, Arm 3 = -0.82. Conclusions: Non-pharmacological interventions that positively affect nausea expectancies have the promise of adding substantially to nausea control. Supported by ACS grant RSG-01–071-PBP No significant financial relationships to disclose.