A Randomized Clinical Trial of Group Acupuncture for Painful Diabetic Neuropathy Among Diverse Safety Net Patients

Autor: Frederick Hecht, Maria T. Chao, Unity Nguyen, Trilce Santana, Dean Schillinger, Steve Gregorich, Rhianon Liu
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Clinical Trials and Supportive Activities
Clinical Sciences
Acupuncture Therapy
Pain
law.invention
Diabetic Neuropathies
Quality of life
Randomized controlled trial
Clinical Research
Anesthesiology
law
Rating scale
Diabetes mellitus
Complementary and Integrative Health
Diabetes Mellitus
medicine
Acupuncture
Humans
Peripheral Neuropathy
business.industry
Diabetes
Pain Research
Neurosciences
Pharmacology and Pharmaceutical Sciences
General Medicine
Middle Aged
medicine.disease
INTEGRATIVE MEDICINE SECTION
Confidence interval
Neuropathy
Health Disparities
Anesthesiology and Pain Medicine
Painful diabetic neuropathy
Randomized Clinical Trial
Usual care
Quality of Life
Public Health and Health Services
Physical therapy
Female
Patient Safety
Neurology (clinical)
Chronic Pain
business
Zdroj: Pain medicine (Malden, Mass.), vol 20, iss 11
Pain Med
ISSN: 1526-4637
1526-2375
Popis: Objective Existing pharmacologic approaches for painful diabetic neuropathy (PDN) are limited in efficacy and have side effects. We examined the feasibility, acceptability, and effects of group acupuncture for PDN. Design and Setting We randomized patients with PDN from a public safety net hospital to 1) usual care, 2) usual care plus 12 weeks of group acupuncture once weekly, or 3) usual care plus 12 weeks of group acupuncture twice weekly. Methods The primary outcome was change in weekly pain intensity (daily 0–10 numerical rating scale [NRS] averaged over seven days) from baseline to week 12. We also assessed health-related quality of life and related symptoms at baseline and weeks 6, 12, and 18. Results We enrolled 40 patients with PDN (baseline pain = 5.3). Among participants randomized to acupuncture, 92% attended at least one treatment (mean treatments = 10.1). We observed no significant differences between once- vs twice-weekly acupuncture and combined those groups for the main analyses. Compared with usual care, participants randomized to acupuncture experienced greater decreases in pain during the 12-week intervention period (between-group differences from baseline = –2.06, 95% confidence interval [CI] = –3.01 to –1.10), but benefits were not maintained after acupuncture ended (baseline to week 18 = –0.61, 95% CI = –1.46 to 0.24). Quality of life improved for acupuncture participants (baseline to week 12 difference = 11.79, 95% CI = 1.92 to 21.66), but group differences were not significant compared with usual care (25.58, 95% CI = –3.90 to 55.06). Conclusions Group acupuncture is feasible and acceptable among linguistically and racially diverse safety net patients. Findings suggest clinically relevant reduction in pain from PDN and quality of life improvements associated with acupuncture, with no differences based on frequency.
Databáze: OpenAIRE
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