Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service
- 1Department of Primary Care, Peninsula Medical School, Plymouth University, Plymouth, UK
- 2Parkbury House Surgery, St Albans, UK
- 3Midway Surgery, St Albans, Herts, UK
- 4St Albans and Harpenden MSK CATS
- Correspondence to Dr Adrian White, Department of Primary Care, Peninsula Medical School, Plymouth University, N21 ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK;
Contributors Concept: JF and MR planned and set up the clinic in Parkbury House surgery; PR James Ferguson and Michael Cannell (see Acknowledgements) set up the clinic in Midway Surgery; MB facilitated the clinics within STAHCOM commissioning group;MR, PR and Stephanie Martin-Smith (see Acknowledgements) delivered the acupuncture and collected the clinic data; Julie Brumby (see Acknowledgements) collected MSK CATS referral service data; AW planned the evaluation, analysed the data, drafted the report and is guarantor for the study.
- Received 29 February 2012
- Accepted 28 May 2012
- Published Online First 20 August 2012
Background Acupuncture has been provided in nurse-led group clinics in St Albans since 2008. It is funded by a commissioning group within the National Health Service, on a trial basis, for patients with knee osteoarthritis who would otherwise be referred to an orthopaedic surgeon.
Aim To evaluate the patients seen in the service's first year of operation and their outcome up to the end of 2010.
Methods Service evaluation was made of patient data from the referral centre and the acupuncture clinics, including baseline characteristics, attendance data and Measure Yourself Medical Outcome Profile (MYMOP) symptom, function and well-being scores over at least 2 years.
Results 114 patients were offered acupuncture, of whom 90 patients were assessed in the acupuncture clinics. 41 of these were still attending after 1 year and 31 (34%) after 2 years. MYMOP scores showed clinically significant improvements at 1 month for pain (4.2 (SD 1.2) to 2.9 (SD 1.4)), stiffness (4.1 (SD 1.3) to 2.9 (SD 1.3)) and function (4.5 (SD 1.1) to 3.3 (SD 1.2)) which continued up to 2 years. Well-being scores did not change.
Conclusions This is the first evaluation of nurse-led group (multibed) acupuncture clinics for patients with knee osteoarthritis to include a 2 year follow-up. It shows the practicability of offering a low-cost acupuncture service as an alternative to knee surgery and the service's success in providing long-term symptom relief in about a third of patients. Using realistic assumptions, the cost consequences for the local commissioning group are an estimated saving of £100 000 a year. Sensitivity analyses are presented using different assumptions.
Competing interests AW has received lecture fees and travel expenses from the British Medical Acupuncture Society (BMAS) related to the present work. AW is paid by BMAS as editor of the journal Acupuncture in Medicine and receives royalties on books on acupuncture. The Peninsula Medical School received a research grant from BMAS to cover the costs of another researcher for work related to this study. MR has been paid by BMAS for lecturing. PR: no competing interest declared; JF is a partner in one of the practices where a knee clinic takes place and receives payment as a practice for each treatment; MB: no competing interest declared.
Patient consent Obtained.
Ethics approval Meets the criteria of service evaluation.
Provenance and peer review Not commissioned; externally peer reviewed.