Implementing acupuncture for pain and symptom management among cancer inpatients

Background: Among nearly 5 million cancer patients hospitalized each year, a majority experience pain. Research supports the efficacy of acupuncture for cancer-related pain and symptoms common among inpatients, but findings have not been confirmed in actual clinical practices. 

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.