Friday, November 29, 2013

Acupuncture for Treatment of Uncontrolled Pain in Cancer Patients: A Pragmatic Pilot Study


Integr Cancer Ther. 2013 Nov 25.
Garcia MK, Driver L, Haddad R, Lee R, Palmer JL, Wei Q, Frenkel M, Cohen L.

Abstract

PURPOSE:

Pain control is an ongoing challenge in the oncology setting. Prior to implementing a large randomized trial at our institution, we investigated the feasibility, safety, and initial efficacy of acupuncture for uncontrolled pain among cancer patients.

HYPOTHESE:

Our hypotheses were that the acupuncture treatments provided would be feasible, safe, and a beneficial adjunct to pain management.

STUDY DESIG:

This was a single arm, nonrandomized pragmatic pilot study.

METHOD:

Participants experiencing pain ≥4 on a 0 to 10 numeric rating scale received a maximum of 10 treatments on an individualized basis. Recruitment, attrition, compliance, and adverse events (AEs) were assessed. Pain (Brief Pain Inventory-Short Form), quality of life (MD Anderson Symptom Inventory [MDASI]), and patient satisfaction were assessed at baseline and at the end of treatment.

RESULT:

Of 115 patients screened, 52 (45%) were eligible and agreed to participate. Eleven (21%) were lost to follow-up, leaving 41 who completed all study procedures. No AEs were reported. Mean pain SEVERIT: was 6.0 ± 1.3 at baseline and 3.8 ± 2.0 at follow-up ( : < .0001). Pain INTERFERENC: was 6.2 ± 2.3 at baseline and 4.3 ± 2.8 at follow-up ( : < .0011). On the MDASI, the mean symptom SEVERIT: was 4.6 ± 1.8 at baseline and 3.2 ± 1.9 at follow-up ( : < .0001), and mean symptom INTERFERENC: was 5.8 ± 2.4 at baseline and 4.1 ± 2.9 at follow-up ( : < .002). Prescribed pain medications decreased across the course of the study. Patient satisfaction was high: 87% reported that their expectations were met "very well" or "extremely well"; 90% said they were likely to participate again; 95% said they were likely to recommend acupuncture to others; and 90% reported they found the service to be "useful" or "very useful."

CONCLUSION:

Acupuncture was feasible, safe, and a helpful treatment adjunct for cancer patients experiencing uncontrolled pain in this study. Randomized placebo-controlled trials are needed to confirm these results.

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