Effects of somatic acupoint stimulation on anxiety and depression in cancer patients: An updated systematic review of randomized controlled trials. (May 2023)

• Record Type: Journal Article
• Authors: Wang, Tao; Tan, Jing-Yu (Benjamin); Yao, Li-Qun; Huilin Cheng, ; Zhao, Isabella; Eliseeva, Sabina; Polotan, Mary Janice
• Is Part Of: Complementary therapies in clinical practice. Volume 51(2023)
• Publication Date: 2023-05
• Subjects: Acupuncture -- Acupressure -- Anxiety -- Depression -- Cancer; Integrative medicine -- Periodicals; Integrative medicine -- Research -- Periodicals; Alternative medicine -- Periodicals; 615.5
• DOI: 10.1016/j.ctcp.2023.101735
• Languages: English
• ISSNs: 1744-3881

Abstract

Abstract: Objectives: To explore the effectiveness of somatic acupoint stimulation (SAS) for cancer patients with anxiety and depression. Methods: Thirteen electronic databases were searched systematically until August 2022. Randomized controlled trials (RCTs) investigating SAS for anxiety and/or depression in cancer patients were retrieved. Methodological quality of the included studies was assessed by utilizing the Cochrane Back Review Group Risk of Bias Assessment Criteria. Evidence level was assessed by using the approach of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Both meta-analysis and descriptive analysis were conducted for outcome assessment. Results: Twenty-eight records were finally included including 22 journal articles and six ongoing registered clinical trials. The overall methodological quality and level of evidence of the included studies were suboptimal, with no high-quality evidence identified. Moderate evidence showed that SAS could significantly decrease the anxiety of cancer patients (Acupuncture: [random effect model, SMD = −0.52, 95% CI = −0.79 to −0.24, p = 0.0002] and Acupressure: [random effect model, SMD = −0.89, 95% CI = −1.25 to −0.52, p < 0.00001]. While for depression, although the data analysis indicated that SAS can decrease depression significantly (Acupuncture: [random effect model, SMD = −1.26, 95% CI = −2.08 to −0.44, p = 0.003] and Acupressure: [random effect model, SMD = −1.42, 95% CI = −2.41 to −0.42, p = 0.005]), relevant evidence was rated as low. No statistically significant difference was identified between true and sham acupoints stimulation for both anxiety and depression. Conclusions: This systematic review provides the latest research evidence to support SAS as a promising intervention for alleviating anxiety and depression in cancer patients. However, the research evidence should be interpreted prudently as methodological concerns were identified in some included studies, and some sub-group analyses were performed with a relatively small sample size. More rigorously designed large-scale RCTs with placebo-controlled comparisons are warranted to generate high-quality evidence. Registration: The systematic review protocol has been registered with PROSPERO (CRD42019133070). Highlights: A comprehensive database search was conducted (13 electronic databases and three clinical trial registries) to achieve efficient coverage. The quality of the evidence was assessed by the approach of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Subgroup synthesis was conducted based on the SAS types (acupuncture and acupressure), and the intervention duration (≤4 weeks, 4–8 weeks, and ≥8 weeks) to minimize the clinical heterogeneity. Findings provided updated research evidence that SAS might be a promising approach to improving anxiety and depression in cancer patients. Current evidence on SAS for cancer-related emotional distress is not fully conclusive. More rigorously designed RCTs with appropriate sham comparisons are needed.