Strong, R.A., Georges, J.M., & Connelly, C.D. (2016). Pilot evaluation of auricular acupressure in end-stage lung cancer patients. Journal of Palliative Medicine, 19, 556–558.

To evaluate the effects of auricular acupressure on dyspnea intensity, distress, and oxygen saturation in patients with lung cancer with advanced disease.

Patients were randomly assigned to one of three groups: either standard of care, standard of care with auricular acupressure appropriately placed, or standard of care with placebo placement of auricular acupressure (placed on alternate site on ear not associated with lung function). Acupressure was applied with vaccaria segetalis seed taped to portion of ear associated with lung function, according to traditional Chinese medicine by a licensed accupuncturist. Data was collected twice per day for all participants, each time oxygen saturation was measured with pulse oximeter and the participants completed the Cancer Dyspnea Scale tool. Baseline data was collected on day 1, treatment intervention began on day 2, and data was collected on days 2, 3, and 4.

• N = 11   
• AGE: Adults, specific age not stated
• MALES (%): Unknown  
• FEMALES (%): Unknown
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Diagnosis of lung cancer, 36% inpatient and 64% outpatient hospice/palliative care center

• SITE: Single site   
• SETTING TYPE: Multiple settings    
• LOCATION: Southern California

• PHASE OF CARE: End-of-life care
• APPLICATIONS:  Elder care, palliative care

Randomized controlled trial; participants randomly assigned to three conditions

Cancer Dyspnea Scale, 12-items assessing three dimensions of dyspnea: effort, anxiety, and discomfort using a five-point Likert-type scale. Level of oxygen saturation was measured via pulse oximeter.

Statistical analysis were used as basis for planning for future research design as true analysis was limited by small sample size. No significant relationship was identified for oxygen saturation between the three groups, statistical analysis suggests that the treatment arm had an effect on the measure of dyspnea effort. Data were also analyzed using non-parametric statistic Friedman two-way ANOVA by ranks; running test once for each of the three groups. The only condition that resulted in statistically significant change over time was the auricular acupressure experimental group (chi-squared = 7 and p = 0.43).

Experiment was conducted as a feasibility study showing that the intervention was well-tolerated, with low subject burden and, therefore, auricular acupressure seems to be a feasible intervention with no negative impact. Since subscale of dyspnea effort showed significant change, larger studies are indicated to validate usefulness of intervention to positively affect symptom of dyspnea in end-stage patients with lung cancer.

• Small sample (< 30)
• Findings not generalizable
• Other limitations/explanation: Feasibility study

Use of auricular acupressure to mitigate sensation of dyspnea in patients with advanced lung cancer needs to be studied further with appropriately sized patient populations to accurately measure effect. Use of auricular acupressure did not appear to have negative effects for this small sample size.