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Author MacPherson, H.; Vertosick, E.A.; Foster, N.E.; Lewith, G.; Linde, K.; Sherman, K.J.; Witt, C.M.; Vickers, A.J. url  doi
openurl 
  Title The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain Type of Study Journal Article
  Year 2017 Publication Pain Abbreviated Journal Pain  
  Volume 158 Issue 5 Pages 784-793  
  Keywords Acupuncture Therapy/*methods; Animals; Chronic Pain/*therapy; Humans  
  Abstract There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time after acupuncture, using a large individual patient data set from high-quality randomized trials of acupuncture for chronic pain. The available individual patient data set included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck, and shoulder), osteoarthritis of the knee, and headache/migraine. We used meta-analytic techniques to determine the trajectory of posttreatment pain scores. Data on longer term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a nonsignificant 0.011 SD per 3 months (95% confidence interval: -0.014 to 0.037, P = 0.4) after treatment ended. The central estimate suggests that approximately 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months (95% confidence interval: 0.000-0.050, P = 0.050), suggesting approximately a 50% diminution at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not seem to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture.  
  Address aDepartment of Health Sciences, University of York, York, United Kingdom bDepartment of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA cResearch Institute for Primary Care and Health Sciences, Keele University, Keele, United Kingdom dDepartment of Primary Care, University of Southampton, Southampton, United Kingdom eInstitute of General Practice, Technische Universitat Munchen, Munchen, Germany fGroup Health Research Institute, Seattle, WA, USA gInstitute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland hInstitute for Social Medicine, Epidemiology and Health Economics, Charite-Universitatsmedizin, Berlin, Germany iCenter for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:27764035; PMCID:PMC5393924 Approved no  
  Call Number OCOM @ refbase @ Serial 2220  
Permanent link to this record
 

 
Author MacPherson, H.; Vertosick, E.A.; Foster, N.E.; Lewith, G.; Linde, K.; Sherman, K.J.; Witt, C.M.; Vickers, A.J. url  doi
openurl 
  Title The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain Type of Study Journal Article
  Year 2016 Publication Pain Abbreviated Journal Pain  
  Volume Issue Pages  
  Keywords  
  Abstract There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time following acupuncture, using a large individual patient dataset from high quality randomized trials of acupuncture for chronic pain. The available individual patient dataset included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck and shoulder), osteoarthritis of the knee and headache/migraine. We used meta-analytic techniques to determine the trajectory of post-treatment pain scores. Data on longer-term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a non-significant 0.011 SD per 3 months (95% CI: -0.014 to 0.037, p = 0.4) after treatment ended. The central estimate suggests that about 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months (95% CI: 0.000 to 0.050, p = 0.050), suggesting about a 50% diminution at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not appear to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture.  
  Address 1Department of Health Sciences, University of York, UK 2Memorial Sloan-Kettering Cancer Center, New York, NY, USA 3Research Institute for Primary Care and Health Sciences, Keele University, UK 4University of Southampton, Southampton, UK 5Institute of General Practice, Technische Universitat Munchen, Germany 6Group Health Research Institute, Seattle, WA, USA 7. Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland 8Institute for Social Medicine, Epidemiology and Health Economics,Charite – Universitatsmedizin, Berlin, Germany 9Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:27764035 Approved no  
  Call Number OCOM @ refbase @ Serial 2135  
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