Complementary Therapies


People at a palliative stage of a disease may experience profound emotional and spiritual struggles and their suffering from pain and other symptoms may be debilitating. Complementary therapies (CTs) may be offered alongside conventional treatments to provide relief. Hospices commonly provide CTs such as aromatherapy, massage and reflexology, because of their potential to help alleviate symptoms such as pain, reduce psychological distress, and improve wellbeing. However, there is inconclusive evidence on their effectiveness and questions about their inclusion in clinical guidelines in palliative care. Moreover patients, families and clinicians have identified as a research priority the need to understand the benefits of CTs in palliative and end-of-life care, as well as how and where they are best provided.


1. To undertake a systematic review of randomised controlled trials (RCTs) to determine the effectiveness of aromatherapy, massage and reflexology in alleviating pain, anxiety and improving quality of life in palliative patients.

2. To undertake a systematic review of qualitative studies to explore the perspectives of patients on the benefits and on how best to provide aromatherapy, massage and reflexology in palliative care settings.

3. To integrate findings from the two reviews to permit comparison on (a) what patients see as the benefits and what is measured in the trials, and (b) how patients want the therapies to be provided and how it was provided in the trials. 


Multiple databases such as MEDLINE, EMBASE, and CINAHL will be searched, without date or language restrictions, for search terms related to aromatherapy, massage and reflexology and palliative care. Conference proceedings will be examined, as well as trial registers. Titles and abstracts will be screened independently by two reviewers. Data from full text articles will be extracted into a table and double checked by a second reviewer. Quality assessment of the studies will be done independently by two reviewers. If appropriate, quantitative data will be synthesised in a meta-analysis and qualitative data using a thematic synthesis. Once both reviews are completed we will use a common framework to explore by juxtaposition how their outputs overlap.

This 12 month project began on 13th November 2017 and is funded by the Marie Curie Research Grant Scheme. PROSPERO reference: CRD42017081409.

The Team:

Megan ArmstrongMCPCRD, UCL
Rose AmeyMarie Curie Expert Voices
Judy BoothRoyal Free NHS
Bridget CandyMCPCRD, UCL
Kate FlemmingUniversity of York
Nuriye KupeliMCPCRD, UCL
Veronica MacleanMarie Curie Expert Voices
Jill PrestonIsabel Hospice
Paddy StoneMCPCRD, UCL
Susan WilkinsonUniversity of Liverpool