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#Grand Rounds

Can Self-Acupressure Apps Relieve Dysmenorrhea?

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BACKGROUND AND PURPOSE:

  • Primary dysmenorrhea is common among women of reproductive age, with only approximately a 25% success rate with current treatment (NSAID and OCPs)
  • There is some, potentially biased, evidence regarding benefits of self-acupressure
  • Smartphone apps are becoming more popular to address health issues
  • Mobile health (mHealth) solutions have not been studied using well designed studies/RCTs
  • Blödt et al. (AJOG, 2017) examined whether app-based self-acupressure is effective for women with menstrual pain

METHODS:

  • Two-armed randomized pragmatic trial
  • Inclusion: Women 18-24 years with self-reported cramping pain ≥6 on a numeric rating scale (NRS 0-10)
  • Followed over 6 menstrual cycles
  • All women receive the app, which included visualization of the menstrual cycle, questionnaires and diaries
  • Women were randomized into groups:
    • Intervention: Acupressure specific app features
      • Reminded by app every day, 5 days before expected onset of menses, to apply self-acupressure
      • Explanations of acupressure procedures
      • Timer to guide one-minute acupressure of each point
      • Study data entered through the app
    • Control: Followed usual care only
  • Primary outcome was the mean pain intensity on the days with pain during the third menses cycle
  • Secondarily, pain intensity was assessed at the 1st, 2nd, 3rd, and 6thmenstruation cycle

RESULTS:

  • 221 women with a mean age 24.0 years
  • The acupressure group had significantly lower mean pain intensity during the third menstruation cycle 4.4 (95% CI, 4.0-4.7) vs 5.0 (95% CI, 4.6-5.3)
  • At the sixth cycle, the mean difference between the groups was -1.4 (p<0.001) and reached clinical relevance
  • At the third and sixth menstruation cycle, responder rate was 37% and 58% respectively in the acupressure group, and 23% and 24% in the control group
  • The acupressure group had lower worst pain intensity and the number of days with pain at both third and sixth cycle
  • The acupressure group had fewer women requiring pain medications
    • Odd ratio 0.5 (95% CI, 0.3-0.9) at third cycle and 0.3 (95% CI, 0.2-0.5) at the sixth cycle
  • The number of sick days did not differ between groups
  • On a scale from 0-6, mean satisfaction with the intervention at the third cycle was 3.7, recommendation of the intervention to others was 4.3, appropriateness of acupressure for menstrual pain was 3.9
  • Two third of the women (67.6%) still applied acupressure on all days with pain even after the 6th cycle

CONCLUSION:

  • App-based self-acupressure reduced menstrual pain, with increasing effectiveness over time and good adherence

Learn More – Primary Sources:

Effectiveness of app-based self-acupressure for women with menstrual pain compared to usual care: A randomized pragmatic trial

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