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Longer-term clinical and economic benefits of offering acupuncture to patients with chronic low back pain assessed as suitable for primary care management – 3 month clinical outcomes from a controlled trial of 241 patients
  1. H Macpherson1,
  2. K Thomas2,
  3. J Brazier3,
  4. M Fitter1,
  5. L Thorpe2,
  6. M Campbell4,
  7. J Nicholl2,
  8. M Roman5,
  9. A Morgan3
  1. 1
    Foundation for Traditional Chinese Medicine, York;
  2. 2
    Medical Care Research Unit, University of Sheffield, School of Health and Related Research;
  3. 3
    Sheffield Health Economics Group, University of Sheffield, School of Health and Related Research;
  4. 4
    Institute of General Practice, University of Sheffield, School of Health and Related Research;
  5. 5
    York Primary Care Trust

    Abstract

    Objectives To undertake a pragmatic randomised controlled trial to test the hypothesis that a population of patients with persistent low back pain, when given access to an acupuncture service, gain more relief from pain than those offered usual management only, for equal or less cost.

    Methods The study is a pragmatic randomised controlled trial (n=241). Suitable patients are identified by their general practitioners. Patients randomised to the experimental arm are offered the option of referral for up to 10 individualised treatments from one of six qualified acupuncture practitioners. The control group continues to receive usual management from their general practitioner. The primary scale used for measuring change is the Bodily Pain (SF–36) at 3 months and 12 months post randomisation. The main outcome is cost-effectiveness at 12 months.

    Results A total of 43 general practitioners participated in the trial and 241 patients were randomised. All patients randomised to the option of acupuncture chose to receive treatment. Clinical outcomes at 3 months show that the SF-36 Bodily Pain scores improved by 29.4 and 24.9 points in the acupuncture and normal management group respectively (p=0.125). Patients in the acupuncture group reported lower levels of worry at three months (p<0.001).

    Conclusions It is possible to conduct a large pragmatic randomised controlled trial of acupuncture in a primary care setting. Acupuncture is seen as an acceptable treatment by patients with low back pain. Clinical outcomes at three months suggest that the acupuncture group are in less pain than the control group.

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    Footnotes

    • Abstracts from the highest scoring scientific free papers at the 10th International Congress of Medical Acupuncture and Related Techniques (ICMART) held in Edinburgh from 4th to 6th May 2002

    • One of the papers presented at the congress is published in full in this journal on pages 56–65.

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