More than half of the RCTs (23) used acupuncture based on traditional Chinese techniques. The rest used Western techniques, or a combination of the two. In nine RCTs, acupuncture points were selected according to a fixed acupuncture formula (i.e., the same acupoints were used for all study participants). The remaining trials are either flexible formulas (a fixed formula is used for all participants, and additional points are selected for each participant based on their individual diagnosis or symptoms) or individual formulas (physician points were selected according to the following criteria: stimulating points).
In 80% of RCTs, patients received between 6 and 15 acupuncture treatments. Most patients received acupuncture treatment once or twice a week. In just over half of the RCTs, a typical acupuncture session was less than 30 minutes.
result
“These results support and reinforce previous important findings that acupuncture produces clinically relevant effects compared with no acupuncture,” the authors wrote. There is. These effects appear to last for at least 12 months after receiving acupuncture treatment. The authors added that “the effects of acupuncture cannot be fully explained in terms of a placebo effect,” but that “factors other than the specific effect of inserting the needles at the correct acupuncture point locations” may contribute to the effects of receiving acupuncture. He warned that it was contributing to the profits that could be made.
The authors addressed the issue of effect size and relevance. They compared acupuncture versus non-acupuncture because doctors’ decisions when treating or referring patients “are made between acupuncture and non-acupuncture, not between acupuncture and sham treatment.” He argued that relevance should be determined by
They suggested that considering acupuncture for chronic pain patients is a “reasonable option” and called for additional research to determine the best way to incorporate acupuncture into the care of these patients. Ta.
Family doctor’s perspective
said Dr. Jennifer Frost, medical director of AAFP’s Division of Public Health and Science. AAFP News Non-drug treatments such as acupuncture may benefit some patients. This is especially important given the impact of the ongoing opioid epidemic on pain management.
However, FPs may also require further guidance regarding the effectiveness of these treatments. “Many family physicians are receptive to ‘alternative’ therapies such as acupuncture, but are reluctant to prescribe them without training in the benefits, harms, and indications,” Frost says.
Another hurdle is payment for services. “Most insurance plans do not cover acupuncture, which greatly reduces access,” she said.
Some organizations, such as the American Academy of Medical Acupuncture, offer workshops and refresher courses for physicians to receive training. Frost explained that her practice has an integrative medicine clinic where she can refer patients to other family physicians who have more expertise in the field. Those doctors will assess the patient’s needs and determine the appropriate treatment.
However, overall, the number of FPs trained in medical acupuncture is small. For the time being, patients seeking acupuncture will likely be referred to another health care professional for treatment. Therefore, to ensure that patients receive the best treatment, it is important for family physicians to be aware of the professionals who provide quality acupuncture in their area.
“Some family doctors are trained in acupuncture, but most will refer you to this treatment. “We need to know,” Frost said.
AAFP details
American family physician: Effective complementary/integrative therapies: A review of the evidence.
(2016/9/1)
American family physician: Acupuncture for pain
(2009/9/1)
Familydoctor.org: Chronic pain
additional resources
American Board of Family Medicine Journal: Key elements for practicing acupuncture in family medicine: patient and physician perspectives.
(March/April 2018)
Mayo Clinic Minutes: Evidence-based evaluation of complementary health approaches for pain management in the United States
(September 2016)
BMJ: Should doctors recommend acupuncture for pain?
(2018/3/7)
