Acupuncture safety: what patients report on adverse events

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Acupuncture safety what patients report on
adverse events

• Hugh MacPherson1,Tony Scullion1,
• Kate Thomas2, Stephen Walters2
• 1 Foundation for Traditional Chinese Medicine,
  York.
• 2 University of Sheffield

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Aims of study are to..

• Find out from patients their experience of
  adverse events
• Identify adverse events associated with
• Advice from acupuncturists to reduce or stop
  prescribed conventional medication
• Delayed conventional diagnosis or treatment

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But what do patients say?

• .the one source of experience that remains
  largely ignored .
• Patients have a key role to play in
  identifying adverse events ..

Vincent Coulter QSHC 2002 11 76-80
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What about delayed conventional diagnosis?

• Since acupuncture is used as a complete medical
  system, . a sinister underlying cause. (may be)
  missed
• Ernst E. 2001 Desktop Guide to Complementary
  Alternative Medicine

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What about delayed conventional treatment?

• With depressing regularity we hear of.delayed
  access to potentially life-saving conventional
  treatment.
• Ernst E. 2001 Desktop Guide to Complementary
  Alternative Medicine

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What about acupuncturists advising a change to
prescribed medication?

• (Practitioners) . have the unfortunate habit of
  doing this.
• Ernst E. 2001 Desktop Guide to Complementary
  Alternative Medicine

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What we planned to doa prospective patient
survey

• All 1955 practitioners of the British
• Acupuncture Council invited
• Identify up to 60 consecutive patients each
• Patients posted signed consent forms to centre
• Three month questionnaires posted direct to
  patients from centre
• Target of 30,000 consultations

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Survey results

• 638 BAcC practitioners participated
• 9,408 patients consented
• 6,348 three-month questionnaires received (67)
• reports covered 30,196 treatments

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About the patients

• 76 female 24 male
• 52 years average age
• 4 acupuncture paid by state
• 11 not had acupuncture before

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Pathway to acupuncture
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Main conditions being treated
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Patients short-term reactions to acupuncture
(n9408)
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Commonest significant events

• No. events 1044
• Reported by 682 patients

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Serious adverse events over three months

• Three events occurred
• Hospital admission 1
• patient, with cancer, had severe pain (8244)
• Life threatening 2
• patient became severely ill, then cathartic
  (3265)
• patient, two days after treatment, fell asleep at
  wheel and crashed her car (5721)
• Permanent disability 0

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Did your acupuncturist advise you to reduce or
stop taking medication prescribed by your doctor?

• 196 (3) patients reported yes
• of whom 6 patients reported adverse consequences
  
• - hydrocortisone skin cream (4704)
• - antidepressant Seroxat (7122)
• - antidepressant Seroxat (7248)
• - antidepressant Setraline (8851)
• - hormone replacement therapy (8995)
• - medication unknown (9355)

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Did your acupuncturist advise you to consult
your GP or hospital specialist?

• 5527 (87) patients reported no
• of whom 2 patients also reported adverse
  consequences
• - 1 patient cost of ineffective
  acupuncture for jaw pain, subsequent tooth
  extraction (3611)
• - 1 patient prolonged urinary tract
  infection, subsequent antibiotics (6348)

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Absolute risk

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Relative risk

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Would you be willing to have acupuncture again?

• Of the 682 patients who had a significant
  adverse event,
• 40 (6) would not want to have acupuncture again

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Conclusions

• Serious adverse event rate is very low
• Indirectly caused adverse events are infrequent
• No evidence that patients outside state health
  system are at higher risk
• Despite adverse events, almost all willing to
  continue with acupuncture

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Acknowledgements

•  
• 9,408 Patients
• 638 Practitioners

• Research Team
•  
• Hugh MacPherson
• Tony Scullion
• Kate Thomas
• Stephen Walters