Positive Health Online

Abstract

BRIDGET and COLLEAGUES, 1 Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK; 2 Department of Health Sciences, University of York, York, UK.;3 Palliative Care Institute Liverpool, University of Liverpool, Liverpool, UK review conducted a systematic review of randomized controlled trials to synthesize current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs.

Background

Aromatherapy, massage and reflexology are widely used in palliative care. Despite this, there are questions about their suitability for inclusion in clinical guidelines. The need to understand their benefits is a public priority, especially in light of funding pressures.

Methodology

Aim: To synthesise current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs. Design: A systematic review of randomised controlled trials (PROSPERO CRD42017081409) was undertaken following international standards including Cochrane guidelines. The quality of trials and their pooled evidence were appraised. Primary outcomes on effect were anxiety, pain and quality-of-life. Data sources: Eight citation databases and three trial registries were searched to June 2018.

Results

Twenty-two trials, involving 1956 participants were identified. Compared with a control, four evaluated aromatherapy, eight massage and six reflexology. A further four evaluated massage compared with aromatherapy. Trials were at an unclear risk of bias. Many had small samples. Heterogeneity prevented meta-analysis. In comparison with usual care, another therapy or an active control, evidence on the effectiveness of massage and aromatherapy in reducing anxiety, pain and improving quality-of-life was inconclusive. There was some evidence (low quality) that compared to an active control, reflexology reduced pain.

Conclusion

This review identified a relatively large number of trials, but with poor and heterogeneous evidence. New clinical recommendations cannot be made based on current evidence. To help provide more definitive trial findings, it may be useful first to understand more about the best way to measure the effectiveness of these therapies in palliative care.

References

Bridget Candy  1 , Megan Armstrong  1 , Kate Flemming  2 , Nuriye Kupeli  1 , Patrick Stone  1 , Victoria Vickerstaff  1 , Susie Wilkinson  3. The effectiveness of aromatherapy, massage and reflexology in people with palliative care needs: A systematic review. Palliat Med.; 34(2):179-194. Feb 2020. doi: 10.1177/0269216319884198. Epub Oct 29 2019 .