The efficacy of acupressure in managing opioid-induced constipation in patients with cancer: A single-blind randomized controlled trial

• Published in: Supportive care in cancer Vol. 30; no. 6; pp. 5201 - 5210
• Main Authors: Yildirim, Dilek, Kocatepe, Vildan, Talu, Gül Köknel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2022; Springer; Springer Nature B.V
• Subjects: Acupressure; Acupuncture; Analgesics, Opioid - adverse effects; Analysis; Cancer; Cancer patients; Care and treatment; Clinical trials; Constipation; Constipation - chemically induced; Constipation - therapy; Humans; Medicine; Medicine & Public Health; Narcotics; Neoplasms - complications; Neoplasms - drug therapy; Nursing; Nursing Research; Oncology; Opioid-Induced Constipation; Original Article; Pain Medicine; Quality of Life; Questionnaires; Rehabilitation Medicine; Single-Blind Method; Treatment Outcome; Opioid-induced constipation; Complementary medicine; Acupressure; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-022-06947-1

Purpose Opioid-induced constipation is one of the heath problems with a negative impact on the quality of life. This randomized-controlled trial aimed to investigate the effects of acupressure therapy on the management of opioid-induced constipation in patients with cancer. Methods The trial was conducted on 140 cancer patients, who were assigned to the acupressure ( n  = 70) and the control groups ( n  = 70). In addition to routine care, patients in the acupressure group received 8-min acupressure from the Zhongwan (CV12), Guanyuan (CV4), and Tianshu (ST25) acupoints once a day for 4 weeks. The outcomes included Defecation Diary (DD), Visual Analog Scale Questionnaire (VASQ), and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL). Results We found a statistically significant difference between the acupressure and control groups in terms of stool consistency (2.22 ± 0.49 vs 1.80 ± 0.55) ( p  = 0.001), straining (1.98 ± 0.71 vs 2.91 ± 0.37) ( p  = 0.001), incomplete evacuation (0.37 ± 0.29 vs 0.61 ± 0.43) ( p  = 0.001), stool amount (0.93 ± 0.14 vs 0.95 ± 0.20) ( p  = 0.001), and the number of defecations (0.70 ± 0.22 vs 0.46 ± 0.29), ( p  = 0.001) measured at the fifth week. Besides, with the exception of stool amount, the DD scores obtained by the acupressure group significantly increased in the fifth week. Inter-group comparison of the pre-test and post-test scores showed that acupressure group obtained statistically significantly lower scores from the PAC-QOL ( p  = 0.0001). Conclusions Findings of this trial suggested that a 4-week acupressure was an effective way to improve the quality of life and to reduce both the subjective and the objective constipation symptoms in patients with opioid-induced constipations. Clinical Trial Number: NCT 04876508