Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2002; 7: 113
To undertake a collaborative study 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. To inform future purchasing decisions regarding the provision of traditional acupuncture by the National Health Service.
The study is a pragmatic, randomised controlled trial in a primary care setting (n = 240). Patients were randomly allocated to the offer of acupuncture versus usual management only from their general practitioner (GP). The primary outcome measure is change in Bodily Pain (SF-36) at 3 months, 12 months and 24 months post randomisation. The main outcome is cost-effectiveness at 12 months.
A total of 43 GPs in York (34%) participated in the trial and 241 patients were successfully randomised over an 18-month period. All patients randomised to the offer of acupuncture chose to receive treatment. Acupuncture patients received an average of eight treatments from one of six acupuncturists in addition to any GP care, and reported high levels of satisfaction with their care. Of the patients in the usual management group, 80% received an intervention; 42% received physiotherapy. More GP visits were recorded for the usual management group. Clinical outcomes for all patients at 3 months favour the acupuncture group, with consistent but non-significant differences between changes in scores for Bodily Pain (SF-36), other SF-36 dimensions, and two additional back pain measures (Oswestry and McGill).
It is possible to conduct a successful pragmatic trial of complementary and alternative medicine in a primary care setting. Clinical outcomes at 3 months indicate potential for cost-effectiveness at 12 months and 24 months.
