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Correia de Carvalho M, Azevedo P, Pires C, Machado JP, Laranjeira M, Nunes de Azevedo J. Integrating Acupuncture into a Dialysis Center. Healthcare (Basel) 2023; 11:healthcare11101463. [PMID: 37239749 DOI: 10.3390/healthcare11101463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/07/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
A growing interest in integrating traditional Chinese medicine (TCM) and conventional medicine (CM) to create a more comprehensive approach to healthcare has been verified. Scientific evidence supports acupuncture as an integrative treatment for specific health conditions. The aim of this study was to assess the acceptance and feasibility by patients and healthcare professionals of integrating acupuncture in a dialysis center. Individuals undergoing hemodialysis (HD) who participated in a patient-assessor-blinded randomized controlled trial that evaluated the effect of acupuncture on functional capacity and quality of life were included. Acceptance was measured by adherence (percentage of patients who completed treatments and dropouts) and patients' and healthcare professionals' opinions toward acupuncture (pre- and pro-intervention questionnaires). Feasibility was measured by safety (number of reported adverse events) and effectiveness (changes in functional capacity, peripheral muscle strength, and health-related quality of life scores after treatment). Forty-eight patients were included, and forty-five (93.8%) were analyzed. No adverse events were reported. All patients completed the treatment, and only three patients (6.2%) were lost to the 12-week post-treatment follow-up. The attitudes of patients and health professionals were favorable to acupuncture, namely in relation to its use, degree of discomfort, recommendation to others, and interference with routine care and clinical setting. Integrating acupuncture into a dialysis center seems viable and well-accepted by patients with kidney failure on maintenance HD, doctors and nurses.
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Affiliation(s)
| | - Pedro Azevedo
- TECSAM-Tecnologia e Serviços Médicos SA, 5370-530 Mirandela, Portugal
| | - Carlos Pires
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Jorge Pereira Machado
- ICBAS-School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- CBSin-Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal
| | - Manuel Laranjeira
- ICBAS-School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- INC-Instituto de Neurociências, 4100-141 Porto, Portugal
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ATAYOGLU AT, TOKAÇ M, DOĞAN S, GÜNER A, KOCAYİĞİT E, GÜNER M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care 2023. [DOI: 10.22391/fppc.1192917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine
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Affiliation(s)
- Ali Timucin ATAYOGLU
- Department of Family Medicine, International School of Medicine, Istanbul Medipol University, Istanbul
| | - Mahmut TOKAÇ
- Department of History of Medicine and Ethics, Faculty of Medicine, Istanbul Medipol University, Istanbul
| | - Sibel DOĞAN
- Department of Nursing, Faculty of Health Sciences, Istanbul Medipol University, Istanbul
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Zhang NM, Vesty G, Zheng Z. Healthcare Professionals' Attitudes to Integration of Acupuncture in Western Medicine: A Mixed-Method Systematic Review. Pain Manag Nurs 2021; 22:684-693. [PMID: 33962872 DOI: 10.1016/j.pmn.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/13/2020] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acupuncture is practiced in many Western countries with increasing evidence supporting its use across the healthcare system. However, this nonpharmacological intervention is yet to be widely integrated into hospitals. Fundamental to the integration of any innovation into healthcare systems is the attitudes of healthcare professionals. AIMS To explore healthcare professionals' attitudes towards acupuncture and identify the enablers and barriers to integration in the hospital setting. DESIGN This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines; we conducted a mixed-method systematic review following Joanna Briggs Institute Reviewer's Manual 2017. DATA SOURCES PubMed, CINAHL, AMED, EMBASE, Cochrane Library, and SCOPUS were searched from their inception to December 2019 using different combination of keywords. METHODS Attitude and perception data were extracted from the articles and constructs were categorized as barriers and enablers. A convergent integrated approach was adopted whereby qualitative data themes were integrated with quantitative data constructs to generate descriptive codes around enablers and barriers at intrapersonal, interpersonal, and environmental levels according to the framework proposed by Manias et al. (2014). RESULTS Twenty-six studies comprising 19 survey and seven interview studies were identified, with 24 articles (92%) reporting positive attitudes, supporting the integration of acupuncture into Western medicine. Enablers identified were prior positive experience, belief in the treatment's efficacy, and patient demand. Barriers were lack of evidentiary knowledge or experience; lack of resources such as time, providers, and funding; and paradigm differences. Twenty studies (77%) focused on medical doctors or medical student perceptions. A conceptual framework for implementing and integrating acupuncture into Western medicine is proposed. CONCLUSION Healthcare professionals' attitudes to acupuncture are positive. Barriers to integrating acupuncture into the hospital system exist at intrapersonal, interpersonal, and external levels, with lack of resources being the key barrier. Nurses' role in facilitating integration into Western medical pain management practice provides an avenue for future research. The proposed conceptual framework provides guidance for nursing researchers interested in the role of acupuncture and integrated medicine in patient-centric, value-based healthcare.
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Affiliation(s)
- Nancy Ming Zhang
- School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.
| | - Gillian Vesty
- School of Accounting, Information Systems and Supply Chain, RMIT University, Melbourne, Australia
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Australia
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Sharp D, Lorenc A, Little P, Mercer SW, Hollinghurst S, Feder G, MacPherson H. Complementary medicine and the NHS: Experiences of integration with UK primary care. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Sharp D, Lorenc A, Feder G, Little P, Hollinghurst S, Mercer S, MacPherson H. 'Trying to put a square peg into a round hole': a qualitative study of healthcare professionals' views of integrating complementary medicine into primary care for musculoskeletal and mental health comorbidity. BMC Complement Altern Med 2018; 18:290. [PMID: 30373580 PMCID: PMC6206651 DOI: 10.1186/s12906-018-2349-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/09/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Comorbidity of musculoskeletal (MSK) and mental health (MH) problems is common but challenging to treat using conventional approaches. Integration of conventional with complementary approaches (CAM) might help address this challenge. Integration can aim to transform biomedicine into a new health paradigm or to selectively incorporate CAM in addition to conventional care. This study explored professionals' experiences and views of CAM for comorbid patients and the potential for integration into UK primary care. METHODS We ran focus groups with GPs and CAM practitioners at three sites across England and focus groups and interviews with healthcare commissioners. Topics included experience of co-morbid MSK-MH and CAM/integration, evidence, knowledge and barriers to integration. Sampling was purposive. A framework analysis used frequency, specificity, intensity of data, and disconfirming evidence. RESULTS We recruited 36 CAM practitioners (4 focus groups), 20 GPs (3 focus groups) and 8 commissioners (1 focus group, 5 interviews). GPs described challenges treating MSK-MH comorbidity and agreed CAM might have a role. Exercise- or self-care-based CAMs were most acceptable to GPs. CAM practitioners were generally pro-integration. A prominent theme was different understandings of health between CAM and general practitioners, which was likely to impede integration. Another concern was that integration might fundamentally change the care provided by both professional groups. For CAM practitioners, NHS structural barriers were a major issue. For GPs, their lack of CAM knowledge and the pressures on general practice were barriers to integration, and some felt integrating CAM was beyond their capabilities. Facilitators of integration were evidence of effectiveness and cost effectiveness (particularly for CAM practitioners). Governance was the least important barrier for all groups. There was little consensus on the ideal integration model, particularly in terms of financing. Commissioners suggested CAM could be part of social prescribing. CONCLUSIONS CAM has the potential to help the NHS in treating the burden of MSK-MH comorbidity. Given the challenges of integration, selective incorporation using traditional referral from primary care to CAM may be the most feasible model. However, cost implications would need to be addressed, possibly through models such as social prescribing or an extension of integrated personal commissioning.
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Affiliation(s)
- Deborah Sharp
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Ava Lorenc
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Gene Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Paul Little
- Primary Medical Care, Faculty of Medicine, University of Southampton, Aldermoor Close, Southampton, SO16 5ST UK
| | - Sandra Hollinghurst
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Stewart Mercer
- General Practice and Primary Care, Institute for Health and Wellbeing, University of Glasgow, 1 Horseletthill Road, Glasgow, G12 9LX UK
| | - Hugh MacPherson
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
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MacPherson H, Vickers A, Bland M, Torgerson D, Corbett M, Spackman E, Saramago P, Woods B, Weatherly H, Sculpher M, Manca A, Richmond S, Hopton A, Eldred J, Watt I. Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants Appl Res 2017. [DOI: 10.3310/pgfar05030] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BackgroundThere has been an increase in the utilisation of acupuncture in recent years, yet the evidence base is insufficiently well established to be certain about its clinical effectiveness and cost-effectiveness. Addressing the questions related to the evidence base will reduce uncertainty and help policy- and decision-makers with regard to whether or not wider access is appropriate and provides value for money.AimOur aim was to establish the most reliable evidence on the clinical effectiveness and cost-effectiveness of acupuncture for chronic pain by drawing on relevant evidence, including recent high-quality trials, and to develop fresh evidence on acupuncture for depression. To extend the evidence base we synthesised the results of published trials using robust systematic review methodology and conducted a randomised controlled trial (RCT) of acupuncture for depression.Methods and resultsWe synthesised the evidence from high-quality trials of acupuncture for chronic pain, consisting of musculoskeletal pain related to the neck and low back, osteoarthritis of the knee, and headache and migraine, involving nearly 18,000 patients. In an individual patient data (IPD) pairwise meta-analysis, acupuncture was significantly better than both sham acupuncture (p < 0.001) and usual care (p < 0.001) for all conditions. Using network meta-analyses, we compared acupuncture with other physical therapies for osteoarthritis of the knee. In both an analysis of all available evidence and an analysis of a subset of better-quality trials, using aggregate-level data, we found acupuncture to be one of the more effective therapies. We developed new Bayesian methods for analysing multiple individual patient-level data sets to evaluate heterogeneous continuous outcomes. An accompanying cost-effectiveness analysis found transcutaneous electrical nerve stimulation (TENS) to be cost-effective for osteoarthritis at a threshold of £20,000 per quality-adjusted life-year when all trials were synthesised. When the analysis was restricted to trials of higher quality with adequate allocation concealment, acupuncture was cost-effective. In a RCT of acupuncture or counselling compared with usual care for depression, in which half the patients were also experiencing comorbid pain, we found acupuncture and counselling to be clinically effective and acupuncture to be cost-effective. For patients in whom acupuncture is inappropriate or unavailable, counselling is cost-effective.ConclusionWe have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed. When all trials are analysed, TENS is cost-effective. Promising clinical and economic evidence on acupuncture for depression needs to be extended to other contexts and settings. For the conditions we have investigated, the drawing together of evidence on acupuncture from this programme of research has substantially reduced levels of uncertainty. We have identified directions for further research. Our research also provides a valuable basis for considering the potential role of acupuncture as a referral option in health care and enabling providers and policy-makers to make decisions based on robust sources of evidence.Trial registrationCurrent Controlled Trials ISRCTN63787732.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin Bland
- Department of Health Sciences, University of York, York, UK
| | | | - Mark Corbett
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Eldon Spackman
- Centre for Health Economics, University of York, York, UK
| | - Pedro Saramago
- Centre for Health Economics, University of York, York, UK
| | - Beth Woods
- Centre for Health Economics, University of York, York, UK
| | | | - Mark Sculpher
- Centre for Health Economics, University of York, York, UK
| | - Andrea Manca
- Centre for Health Economics, University of York, York, UK
| | | | - Ann Hopton
- Department of Health Sciences, University of York, York, UK
| | - Janet Eldred
- Department of Health Sciences, University of York, York, UK
| | - Ian Watt
- Department of Health Sciences/Hull York Medical School, University of York, York, UK
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Greville-Harris M, Hughes J, Lewith G, Liossi C, White P, Graham CA, Bishop FL. Assessing knowledge about acupuncture: A survey of people with back pain in the UK. Complement Ther Med 2016; 29:164-168. [PMID: 27912942 PMCID: PMC5139617 DOI: 10.1016/j.ctim.2016.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/26/2016] [Accepted: 10/06/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Despite the prevalence of acupuncture treatment in the UK, and the increasing evidence of safety and effectiveness, the information presented to patients by practitioners frequently contains inaccuracies. As knowledge of treatment affects both patient decision-making and treatment outcomes, this study aimed to establish what is known about acupuncture in a sample of people who had, and had not, previously experienced acupuncture. DESIGN A 15-item questionnaire was constructed to assess knowledge of acupuncture. SETTING Online survey of people with a history of back pain. RESULTS 202 participants completed the questionnaire. 66.8% of the sample was female and 33.2% male, with a mean age of 35 years (range 18-74 years). 87.6% had back pain in the past six months, 44.1% currently. 21.8% had previously received acupuncture, and 69.8% had previously read or heard information about acupuncture. On average participants answered 11.03 of 15 questions about acupuncture correctly (SD=2.64). Items relating to common concerns about acupuncture, acupuncture efficacy, and types of acupuncture were correctly answered by ≥80% of participants. Participants possessed less knowledge of accessibility, Government legislation, and methods of administration. CONCLUSIONS The study identified key gaps in knowledge about acupuncture among patients. In particular, many participants were unaware that acupuncture is available from the UK National Health Service and that acupuncturists are not subject to statutory regulation in the UK. These knowledge gaps should be addressed in order to increase people's understanding of and access to acupuncture.
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Affiliation(s)
| | - John Hughes
- Royal London Hospital for Integrated Medicine, UCLH NHS Trust, London, UK
| | - George Lewith
- School of Medicine, University of Southampton, Southampton, UK
| | - Christina Liossi
- Department of Psychology, University of Southampton, Southampton, UK
| | - Peter White
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Cynthia A Graham
- Department of Psychology, University of Southampton, Southampton, UK
| | - Felicity L Bishop
- Department of Psychology, University of Southampton, Southampton, UK.
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Cheshire A, Peters D, Ridge D. How do we improve men's mental health via primary care? An evaluation of the Atlas Men's Well-being Pilot Programme for stressed/distressed men. BMC Fam Pract 2016; 17:13. [PMID: 26831720 PMCID: PMC4736718 DOI: 10.1186/s12875-016-0410-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/22/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men's Well-being Programme was designed to engage stressed/distressed men who were patients at a London-based GP surgery. Atlas encouraged GPs to identify and refer men for counselling and/or acupuncture by raising their awareness of men's distress. The aim of this pilot study was to evaluate Atlas in terms of patients' characteristics, service utilisation, patient outcomes and cost implications. METHODS All patients using the Programme were asked to complete a questionnaire before and after their Atlas sessions. Outcome measures included the Hospital Anxiety and Depression scale, Perceived Stress Scale, Warwick-Edinburgh Mental Well-being Scale, a 11-point scale measuring physical health, and the Psychological Outcome Profiles (PSYCHLOPS), a patient-generated outcome measure. Additionally, for cost calculations, participants were asked about their employment, number of days off work due to illness, and their health and social care service use. RESULTS 102 participants were recruited, 82 completed pre- and post-treatment questionnaires. Comparisons pre- and post-treatment revealed a statistically significant improvement in anxious mood (p <0.001), perceived stress (p < 0.001), positive well-being (p = <0.001), PSYCHLOPS (p = <0.001) and physical health (p = 0.001), though not depressed mood (p = 0.660). Additionally, reductions in costs related to lost employment and health and social care use, exceeded the cost of Atlas counselling and acupuncture sessions, with an average saving of nearly £700 per patient. CONCLUSIONS Atlas attendance was associated with improvements in patients' mental and physical health, and demonstrated likely cost savings. It is now important to understand patient and stakeholder perspectives. Further research could compare usual care with the Atlas approach, and investigate full cost-effectiveness.
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Affiliation(s)
- Anna Cheshire
- Department of Psychology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
| | - David Peters
- Westminster Centre for Resilience, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
| | - Damien Ridge
- Department of Psychology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
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10
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Flesch H. Comments on baer and colleagues' "A dialogue between naturopathy and critical medical anthropology: what constitutes holistic health?". Med Anthropol Q 2012; 26:287-91. [PMID: 22905445 DOI: 10.1111/j.1548-1387.2012.01209.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fixler M, Ogden C, Moir F, Polley MJ. Patient experience of acupuncture provision in a GP practice. Complement Ther Clin Pract 2012; 18:140-4. [PMID: 22789787 DOI: 10.1016/j.ctcp.2012.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/14/2012] [Accepted: 03/14/2012] [Indexed: 11/16/2022]
Abstract
UNLABELLED Patient experience of acupuncture at a GP surgery was evaluated over 18 months. Patients were referred for six acupuncture treatments of 45 min by 10 practising GPs. Measure Your Medical Outcome Profile (MYMOP), was completed before the first treatment and at the start of the final consultation. A patient experience survey was completed immediately after the patient's last appointment. RESULTS A statistically and clinically significant improvement in the mean MYMOP profile score (1.6 SD 1.3, p < 0.0000) (n = 47); reduction in medication usage; a reduction in pain and stress and improved quality of life. CONCLUSIONS Acupuncture provision was beneficial to patients with predominately chronic conditions. Further studies are needed to assess the cost effectiveness and long term benefit of acupuncture in the NHS.
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Affiliation(s)
- M Fixler
- Highgate Acupuncture Practice, 82 Priory Gardens, London N6 5QS, UK
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Estrin Dashe AA. Integrating massage, chiropractic, and acupuncture in university clinics: a guided student observation. Int J Ther Massage Bodywork 2012; 5:3-8. [PMID: 22811755 PMCID: PMC3390215 DOI: 10.3822/ijtmb.v5i2.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Several studies have reported on the health benefits of applying an integrated complementary health care model. PURPOSE This paper presents the results of pilot research focusing on the observations massage therapy students made about complementary health care education and integration during massage, chiropractic, and acupuncture treatments at two university clinics. SETTING Observations took place at Northwestern Health Sciences University's associated clinics that offered massage, chiropractic, and acupuncture. RESEARCH DESIGN Students directly observed how clinicians and interns educated their patients and integrated other forms of complementary health care into their practice. PARTICIPANTS chiropractors, massage therapists, and acupuncturists, and their patients. All participants were English-speaking and 18-65 years old. MAIN OUTCOME MEASURES Observations recorded by students in journals about education and integration during massage therapy, chiropractic, and acupuncture treatments were coded and counted. RESULTS Qualitative observations showed that clinicians and interns educated patients to some degree, but the clinicians were less apt to integrate other modalities than the interns. CONCLUSIONS Observations support that professional integrity may limit clinicians in their ability to integrate multiple modalities of health care while treating patients. Since it is well established that integration of multiple health care modalities is beneficial to patient health, it is recommended that clinics assist their clinical staff in applying an integrative approach to their practice.
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Affiliation(s)
- Alejandra A. Estrin Dashe
- College of Undergraduate Health Sciences, Northwestern Health Sciences University, Bloomington, MN, USA
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Hehir L, Williams S. A survey of health professionals’ views about integration of Traditional Chinese Medicine (TCM) Acupuncture into NHS Scotland. Eur J Integr Med 2012. [DOI: 10.1016/j.eujim.2011.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Background There is relatively limited knowledge about the practitioners who provide acupuncture treatment within the UK, what conditions patients consult for and the treatment provided. Objectives To characterise the conditions treated and by whom, to examine characteristics of the treatment and to explore trends over time. Method A cross-sectional survey of the UK acupuncture practitioners was conducted; 800 practitioners were selected by computer-generated randomisation sequences from the four major UK-based professional associations. Data collected on the practitioners included demographic details, association membership, statutorily regulated status, practice setting, style of acupuncture, diagnostic methods and needle response sought. Practitioners recorded details of their 10 most recent patients, including demographic details, primary reason for consulting and lifestyle advice provided. Results 330 practitioners responded comprising doctors (29%) physiotherapists (29%), nurses (15%) and independent acupuncturists (27%): 62% were women with median age of 48 years. The majority (68%) practiced in independent settings and 42% practiced within the National Health Service. Patients most commonly consulted for low back, neck, shoulder and knee pain, as well as headaches and migraine. Treatment for infertility by independent acupuncturists was found to have increased fivefold in 10 years. Conclusion Acupuncture provides a substantial contribution to the healthcare of the UK, with an estimated 4 million sessions provided annually. The primary complaints for which patients consult reflect the growing evidence base on acupuncture for these conditions. These data provide a basis for decision-making regarding policy and practice.
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Affiliation(s)
- A K Hopton
- Department of Health Sciences, University of York, York, UK
| | - S Curnoe
- The Acupuncture Clinic, Great Bowden, Market Harborough, Leicestershire, UK
| | - M Kanaan
- Department of Health Sciences, University of York, York, UK
| | - H MacPherson
- Department of Health Sciences, University of York, York, UK
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Tempest H, Reynard J, Bryant RJ, Hamdy FC, Larré S. Acupuncture in urological practice—A survey of urologists in England. Complement Ther Med 2011; 19:27-31. [DOI: 10.1016/j.ctim.2010.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/27/2010] [Accepted: 10/19/2010] [Indexed: 11/20/2022] Open
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Abstract
This literature review sets out to investigate the effectiveness of acupressure and acupuncture in preventing and managing postoperative nausea and vomiting (PONV) in adult patients. PONV is problematic, affecting patient satisfaction, delayed discharge and even patient re-admission. Current treatment of PONV constitutes a variety of drug therapies, which are only partially effective. With the integration of complementary and alternative medicines in healthcare, this review examined 10 research studies investigating the use of acupressure and acupuncture in treating PONV. Three studies found acupressure to be effective in preventing PONV. However, population samples were small and the research designs had numerous anomalies. Overall the article suggests that acupuncture and acupressure are ineffective in preventing and managing PONV in adult patients. Further investigation of the effectiveness of acupressure and acupuncture, combined with current drug therapies, using well designed and adequately powered studies is needed. Published studies predominantly examined the use of P6 as the pressure point. Further studies should examine other 'acupoint' sites, to ascertain whether these are effective dependent upon the operative site.
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Affiliation(s)
- Jenny Abraham
- Faculty of Health and Life Sciences Coventry University, Coventry, CV1 5FB
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Boon HS, Olatunde F, Zick SM. Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Womens Health 2007; 7:4. [PMID: 17397542 PMCID: PMC1851951 DOI: 10.1186/1472-6874-7-4] [Citation(s) in RCA: 264] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Accepted: 03/30/2007] [Indexed: 11/10/2022]
Abstract
BACKGROUND Use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief. The purpose of this paper is to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer. METHODS Surveys were mailed to women randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 (n = 557) and again in the spring of 2005(n = 877). RESULTS The response rates were 76.3% in 1998 and 63% in 2005. In 1998, 66.7% of women reported using either a CAM product/therapy or seeing a CAM therapist at some time in their lives as compared with 81.9% in 2005 (p = 0.0002). Increases were seen in both use of CAM products/therapies (62% in 1998 vs. 70.6% in 2005) and visits to CAM practitioners (39.4% of respondents in 1998 vs 57.4% of respondents in 2005). Women in 2005 reported that 41% used CAM for treating their breast cancer. The most commonly used products and practitioners for treating breast cancer as reported in 2005 were green tea, vitamin E, flaxseed, vitamin C, massage therapists and dietitians/nutritionists. CONCLUSION CAM use (both self-medication with products and visits to CAM practitioners) increased significantly from 1998 to 2005. Now that more than 80% of all women with breast cancer report using CAM (41% in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an "alternative" or unusual approach to managing breast cancer.
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Affiliation(s)
- Heather S Boon
- Leslie Dan Faculty of Pharmacy and Department of Pharmaceutical Sciences, University of Toronto, 144 College Street, Toronto Ontario, M5S 3M2, Canada
| | - Folashade Olatunde
- Department of Pharmaceutical Sciences, University of Toronto, 144 College Street, Toronto Ontario, M5S 3M2, Canada
| | - Suzanna M Zick
- University of Michigan Comprehensive Cancer Center and University of Michigan Department of Family Medicine, 715 E. Huron, Suite 2E, Ann Arbor, MI 48104, USA
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Abstract
Acupuncture is widely used to alleviate symptoms in a variety of painful conditions. In obstetrics and gynecology, acupuncture has also been applied to a range of conditions including labor pain. This systematic review aims to critically evaluate the evidence on analgesic effect of acupuncture during labor. Computerized literature searches of 7 databases were performed for randomized clinical trials (RCTs) of acupuncture involving needle insertion for pain during labor. Three RCTs were identified and their methodologic quality was generally good. Two RCTs compared adjunctive acupuncture with usual care only and reported a reduction of meperidine and/or epidural analgesia. One placebo acupuncture controlled trial showed a statistically significant difference in both subjective and objective outcome measures of pain. No adverse events were reported in any of the trials. It is concluded that the evidence for acupuncture as an adjunct to conventional pain control during labor is promising but, because of the paucity of trial data, not convincing. Further research is warranted to clearly define its place in labor pain management.
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Affiliation(s)
- Hyangsook Lee
- Department of Oriental Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea.
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