The Effectiveness of Acupressure in Reducing Cancer-Related Fatigue: A Systematic Review and Meta-Analysis

Background: Acupressure is one of the recommended non-pharmacologic treatments for cancer-related fatigue (CRF) according to the National Comprehensive Cancer Network guidelines. However, few systematic review or meta-analysis studies have focused on the effect of acupressure on CRF. Purpose: The purpose of this study was to examine the effectiveness of acupressure in reducing CRF and to identify the effective acupoints and frequencies of acupressure treatments. Methods: The search and screening procedures were conducted in accordance with PRISMA 2009 guidelines. The search database included Embase, CINAHL, Cochrane Library, MEDLINE and Google Scholar. RoB 2.0 and ROBINS-I were used as appraisal tools. The statistical analysis, including effect size estimation, was computed using RevMan 5.4. Results: Twelve studies (15 sets of data) were included in the review and analysis. Nine hundred sixty patients with cancer who were currently undergoing or had completed treatment were enrolled as participants and received different levels of acupressure. The result showed the overall effect size of CRF in reducing acupressure to be SMD=-0.77, 95% CI [-0.90,-0.65]. In the subgroup analysis, the effect size of auricular acupressure was SMD=-0.98, 95% CI [-1.25,-0.71] and the body acupressure effect size was SMD=-0.70, 95% CI [-0.84,-0.56]. Conclusion/Implications for Practice: Based on the results of this systematic review, acupressure may be applied to the body acupoints Hegu (LI4), Zusanli (ST36), and Sanyinjiao (SP6) once daily for 1-3 minutes each and to the auricular acupoints shenmen and subcortex once daily for 3 minutes each to effectively reduce cancer-related fatigue.