Opportunities and Challenges of Implementing a Virtual Acupressure Service for Cancer Patients During COVID-19: A Retrospective Analysis

ABSTRACT

Methods: The study is a retrospective analysis of a virtual acupressure service administered from May to December 2020 at a National Cancer Institute-designated Comprehensive Cancer Center. A semi-standardized virtual acupressure protocol was developed, consisting of 50 min, one-on-one session between the acupuncturist and patient. At the start of each session, the acupuncturist assessed the patient's symptom burden using the Edmonton Symptom Assessment Scale (0-90), for which higher scores represent greater symptom severity. Changes in ESAS scores from baseline to follow-up were evaluated using paired t-test for patients with follow-up within 14 days of baseline. Acupuncturists held weekly group meetings to discuss challenges and ways to improve the delivery of tele-acupressure. Results: A total of 102 virtual acupressure sessions were administered to 32 unique patients. Most patients were females (90.6%) and white (84.4%), the mean age was 55.7 (range=26-82;SD=15.73), and the most common cancer diagnosis was breast (53.1%). Of 32 patients, 13 had follow up in 14 days or less. For these 13 patients, there was a statistically significant reduction in total symptom burden (-4.85±7.6;p=0.04) from baseline to follow-up. Based on the acupuncturists' experiences, various factors were discussed and considered important in implementing virtual acupressure, including effective communications (e.g., both verbal and nonverbal cues), potential technological barriers (e.g., technology literacy), and healing environment (e.g., physical space and/or virtual background appearing on the screen). Background: Oncology acupuncture service was disrupted by COVID-19, and a virtual acupuncturist-guided, patient self-acupressure intervention was implemented. We explore the potential impact of tele-acupressure on patient-reported symptoms and summarize acupuncturists' experiences on the challenges and opportunities of implementing a virtual acupressure service for cancer patients. Conclusion: Virtual acupressure may be a promising therapy for symptom management, especially when in-person acupuncture service may not be feasible, but further research is needed to rigorously evaluate its safety and efficacy among cancer patients.