Implementing acupuncture for pain and symptom management among cancer inpatients
Methods: Concurring with the launch of clinical acupuncture services, we conducted a pilot effectiveness trial on a surgical oncology ward of a university hospital. Participants were randomized to usual care alone or adjunctive acupuncture. Data on daily pain, functional limitations, nausea, and other symptoms were collected using validated instruments.
Results: Among 184 randomized oncology inpatients, mean difference in pain relief between groups was 1.2 on an 11 point numeric rating scale favoring acupuncture. Using hierarchical modeling, worst pain experienced in the past 24 hours decreased by an average of 0.20 points per day in the acupuncture group compared with negligible decreases of 0.023 with usual care patients (p < .05). Differences in overall well being also favored the acupuncture group (mean increase of 1.83 vs. 0.68 for usual care patients, p < .01). Compared with usual care alone, acupuncture was also associated with improved mobility (3.9 vs. 20.3, p < .05) and a trend toward improved self-care (5.5 vs. 14.3, p < .10).
Conclusion: Given the promising findings of our effectiveness pilot and prior efficacy trials of acupuncture among cancer patients, an important next phase of research is to assess adjunctive acupuncture in heterogeneous clinical practice settings and to identify which patients are most likely to benefit from adjunctive acupuncture.
Learning Areas:Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Describe the potential role of non-pharmacologic approaches in cancer pain management. Evaluate the effects of acupuncture on pain and symptom management among hospitalized cancer patients.
Qualified on the content I am responsible for because: I have been the principal investigator on numerous federally funded and foundation grants of integrative health approaches for pain management among diverse patient populations. One area of my program of research has focused on acupuncture as an adjunctive therapy in conventional healthcare settings.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.