Wednesday, March 17, 2010

Research Abstract and Commentary: Aromatherapy Massage

Effectiveness of Aromatherapy Massage in the Management of Anxiety and Depression in Patients with Cancer: A Multicenter Randomized Controlled Trial

Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, Young T, Maher EJ, Ramirez AJ. Journal of Clinical Oncology, 25, 532-538.

PURPOSE: To test the effectiveness of supplementing usual supportive care with aromatherapy massage in the management of anxiety and depression in cancer patients through a pragmatic two-arm randomized controlled trial in four United Kingdom cancer centers and a hospice.
PATIENTS AND METHODS: 288 cancer patients, referred to complementary therapy services with clinical anxiety and/or depression, were allocated randomly to a course of aromatherapy massage or usual supportive care alone.
RESULTS: Patients who received aromatherapy massage had no significant improvement in clinical anxiety and/or depression compared with those receiving usual care at 10 weeks postrandomization (odds ratio [OR], 1.3; 95% CI, 0.9 to 1.7; P = .1), but did at 6 weeks postrandomization (OR, 1.4; 95% CI, 1.1 to 1.9; P = .01). Patients receiving aromatherapy massage also described greater improvement in self-reported anxiety at both 6 and 10 weeks postrandomization (OR, 3.4; 95% CI, 0.2 to 6.7; P = .04 and OR, 3.4; 95% CI, 0.2 to 6.6; P = .04), respectively.
CONCLUSION: Aromatherapy massage does not appear to confer benefit on cancer patients' anxiety and/or depression in the long-term, but is associated with clinically important benefit up to 2 weeks after the intervention.


Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

This randomized controlled trial contributes to the body of evidence about the effectiveness of complementary therapies in cancer, specifically the use of aromatherapy massage (AM). There have been complaints that the “evidence” about complementary therapies is weak or nonexistent. This gives little credence to providers who wish to use these therapies. This study gives strong evidence that in the short-term (two weeks after AM was completed) cancer patients who received AM had less anxiety than patients who did not receive AM. They did not have less depression or other symptoms (e.g., pain, fatigue, nausea and vomiting, global quality of life).

The study intervention was massage with essential oils delivered by massage therapists over 1 hour weekly for 4 weeks. Patients in the treatment group received at least one treatment. Patients in the control group received access to psychological support as part of their cancer care. Patients recruited to the study had been referred to complementary therapy services by a cancer health professional.

Of interest to hospital nurses is that in a pilot study of 57 patients receiving AM, patients showed significantly decreased average anxiety levels immediately after the treatment. This endpoint was not of interest to the researchers, but would be to hospital nurses. This means that immediately following a 1-hour massage with essential oils, patients had less anxiety – on average. No adverse effects from the AM were reported.

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