Despite the advances of modern medicine, one in five patients has symptoms that are unexplained and untreated, contributing to stress for both the provider and individual. Further, studies have shown that the cost of managing the treatment of a patient with medically unexplained symptoms can be twice that of a patient with a diagnosis.
In an effort to provide a solution, a UK research team performed a clinical randomized controlled study on the efficacy of acupuncture for the undiagnosed disorders. Included in the research design was a linked interview of each patient’s subjective opinion of the intervention.
Some 80 patients from GP practices across London were selected to have five-element acupuncture added to their usual care. The results of the research are published in the British Journal of General Practice. The study group was made up of 80 adults, 80 percent female with an average age of 50 years and from a variety of ethnic backgrounds who had consulted their GP at least eight times in the past year. Nearly 60 percent reported musculoskeletal health problems, of which almost two-thirds had been present for a year. The patients were randomly divided into an acupuncture group and a control group. Eight acupuncturists administered individual five-element acupuncture to the acupuncture group immediately, up to 12 sessions over 26 weeks. The same numbers of treatments were made available to the control group after 26 weeks.
At 26 weeks the patients were asked to complete a number of questionnaires including the individualized health status questionnaire “Measure Yourself Medical Outcome Profile.” The acupuncture group registered a significantly improved overall score when compared with the control group. They also showed improved well-being but did not show any change in GP and other clinical visits or the number of medications they were taking. Between 26 and 52 weeks, the acupuncture group maintained their improvement and the control group, now receiving their acupuncture treatments, showed “catch up” improvement. Results from the associated qualitative study, which focused on the patients’ experiences, supported the quantitative work.
This tool identified that participating patients had a variety of longstanding symptoms and disability including chronic pain, fatigue and emotional problems which affected their ability to work, socialize and carry out everyday tasks.
Participating patients reported that their acupuncture consultations became increasingly valuable. They appreciated the amount of time they had with each acupuncturist and the interactive and holistic nature of the sessions – there was a sense that the practitioners were listening to their concerns and, via therapy, doing something positive about them.
This patient-centered orientation encouraged individuals to take an active role in their treatment, resulting in cognitive and behavioral lifestyle changes, such as a new self-awareness about what caused stress in their lives, and a subsequent ability to deal with stress more effectively; and taking their own initiatives based on advice from the acupuncturists about diet, exercise, relaxation and social activities.
Comments from participating patients included: “the energy is the main thing I have noticed. You know, yeah, it’s marvelous! Where I was going out and cutting my grass, now I’m going out and cutting my neighbor’s after because he’s elderly”; “I had to reduce my medication. That’s the big help actually, because medication was giving me more trouble…side effects”; and “It kind of boosts you, somehow or another.”
Dr. Charlotte Paterson, who managed the randomized control trial and the longitudinal study of patients’ experiences, commented: “Our research indicates that the addition of up to 12 five-element acupuncture consultations to the usual care experienced by the patients in the trial was feasible and acceptable and resulted in improved overall well-being that was sustained for up to a year.
“This is the first trial to investigate the effectiveness of acupuncture treatment to those with unexplained symptoms, and the next development will be to carry out a cost-effectiveness study with a longer follow-up period. While further studies are required, this particular study suggests that GPs may recommend a series of five-element acupuncture consultations to patients with unexplained symptoms as a safe and potentially effective intervention.”
She added: “Such intervention could not only result in potential resource savings for the (National Health Service), but would also improve the quality of life for a group of patients for whom traditional biomedicine has little in the way of effective diagnosis and treatment.”
Monday, June 6, 2011
PsychCentral: Acupuncture Effective for Undetermined Illness
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