Feasibility of a Randomized Controlled Trial of Self-Administered Acupressure for Symptom Management in Older Adults with Knee Osteoarthritis

Objectives: To assess the feasibility of a study to evaluate the efficacy of self-administered acupressure in pain and related symptom management for older people with symptomatic knee osteoarthritis. Feasibility with regard to (1) sample recruitment and retention, (2) treatment fidelity and adherence, and (3) tolerability and adverse events was examined. Methods: The study was a randomized controlled trial. Community-living older adults were recruited and randomly assigned to one of three groups: verum acupressure, sham acupressure, and usual care. Participants in the first two groups learned their respective acupressure protocol during their first center visit and from a set of materials. They were asked to practice the protocol at home once daily, 5 days a week, for 8 weeks. Participants attended three center visits and received weekly phone calls from a research assistant in an 8-week study period. Both quantitative and qualitative data collected from center visits and weekly phone calls were used to examine study feasibility. Results: A total of 150 participants (mean age, 73 years; 38% men) were enrolled; 83% completed all three center visits. Among those assigned to verum and sham acupressure groups, 94% passed a fidelity check at the second visit, more than 80% reported performing self-administered acupressure as instructed most of the time, and about 10% reported discomfort from performing the acupressure. Thirty adverse events were reported; most were related to pre-existing health conditions. Conclusions: It is feasible to conduct a study of self-administered acupressure for symptom management in community-living older adults with knee osteoarthritis, although sample recruitment may be challenging.