Background The placebo effect may result in a 40% clinical improvement following administration of a non-active treatment. Complementary therapies such as reflexology are commonplace in palliative care services yet their evidence base is supported by poorly constructed research and subjective clinical outcomes. Cynics have attributed patient-reported responses to the placebo effect.

Method Retrospective data analysis of hospice patients’ pre and post symptom-targeted reflexology using the palliative care outcome scale (POS-S) evaluation tool. Mean symptom difference (MSD) and percentage response (PR) were calculated for each symptom. Placebo adjusted response (PAR) was calculated (PR-40%) with PAR of 20% or above being considered significant.

Results 100 hospice patients received a total of 360 treatment sessions for eight symptoms. (See Abstract 167, Table 1).

Conclusion Adjusting patient-reported response for placebo effect suggests reflexology may have a positive effect on constipation and fatigue. Constipation has long been reported to respond to reflexology and can be objectively evaluated with validated outcome tools. A feasibility study to conduct a randomised controlled trial to compare reflexology with placebo for constipation is in development.