Abstract
Objectives
To measure pain during first trimester medication abortion using auricular acupressure
or auricular acupuncture as an adjunct to pain management. We measured anxiety as
a secondary outcome.
Study design
This randomized, double-blinded, 3-arm trial enrolled women seeking medication abortion
with mifepristone and misoprostol. Participants received auricular acupressure, auricular
acupuncture, or inert auricular placebo patches immediately after receiving mifepristone.
In addition, all participants received ibuprofen to use at home as needed. The study
started with 1:1:1 randomization, but later overenrolled into the acupressure group
after retraining for greater fidelity to that intervention. Participants reported
pain and anxiety using numeric rating scales via text message for 4 days, and using
a visual analog scale at follow-up. Analyses compared median pain scores of those
receiving acupressure, acupuncture, or placebo.
Results
We randomized 136 participants of whom 57 received acupressure, 40 received acupuncture,
and 39 received placebo. Groups had similar baseline characteristics. One hundred
thirty-two participants (97%) reported outcomes by text message and 120 (88%) completed
a follow-up interview. For acupressure, acupuncture and placebo groups the median
maximum pain scores reported via text message were 60.0, 75.0, and 55.0 (p = 0.38); median maximum pain scores reported at follow-up were 76.5, 60.0, and 71.0
(p = 0.97), respectively. Acupressure results were similar before and after retraining.
Maximum anxiety scores reported via text message were 10.0, 45.0, and 30.0 (p = 0.57). Maximum anxiety scores reported at follow-up were 10.5, 20.0, and 13.0 (p = 0.59).
Conclusions
Pain and anxiety during medication abortion were similar among women receiving acupressure,
acupuncture or placebo.
Implications
We found no benefit in administering auricular acupressure or auricular acupuncture
during medication abortion. These modalities are intended to be simple to use, but
perhaps the brief provider training for this study was insufficient. These modalities
should not be used in clinical practice without further study.
Keywords
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Article info
Publication history
Published online: December 16, 2020
Accepted:
December 6,
2020
Received in revised form:
December 3,
2020
Received:
September 15,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc.
