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Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.


ABSTRACT:

Objective

To determine the effects of a policy of "use acupuncture" on headache, health status, days off sick, and use of resources in patients with chronic headache compared with a policy of "avoid acupuncture."

Design

Randomised, controlled trial.

Setting

General practices in England and Wales.

Participants

401 patients with chronic headache, predominantly migraine. Interventions Patients were randomly allocated to receive up to 12 acupuncture treatments over three months or to a control intervention offering usual care.

Main outcome measures

Headache score, SF-36 health status, and use of medication were assessed at baseline, three, and 12 months. Use of resources was assessed every three months.

Results

Headache score at 12 months, the primary end point, was lower in the acupuncture group (16.2, SD 13.7, n = 161, 34% reduction from baseline) than in controls (22.3, SD 17.0, n = 140, 16% reduction from baseline). The adjusted difference between means is 4.6 (95% confidence interval 2.2 to 7.0; P = 0.0002). This result is robust to sensitivity analysis incorporating imputation for missing data. Patients in the acupuncture group experienced the equivalent of 22 fewer days of headache per year (8 to 38). SF-36 data favoured acupuncture, although differences reached significance only for physical role functioning, energy, and change in health. Compared with controls, patients randomised to acupuncture used 15% less medication (P = 0.02), made 25% fewer visits to general practitioners (P = 0.10), and took 15% fewer days off sick (P = 0.2).

Conclusions

Acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. Expansion of NHS acupuncture services should be considered.

SUBMITTER: Vickers AJ 

PROVIDER: S-EPMC381326 | biostudies-literature | 2004 Mar

REPOSITORIES: biostudies-literature

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Publications

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.

Vickers Andrew J AJ   Rees Rebecca W RW   Zollman Catherine E CE   McCarney Rob R   Smith Claire M CM   Ellis Nadia N   Fisher Peter P   Van Haselen Robbert R  

BMJ (Clinical research ed.) 20040315 7442


<h4>Objective</h4>To determine the effects of a policy of "use acupuncture" on headache, health status, days off sick, and use of resources in patients with chronic headache compared with a policy of "avoid acupuncture."<h4>Design</h4>Randomised, controlled trial.<h4>Setting</h4>General practices in England and Wales.<h4>Participants</h4>401 patients with chronic headache, predominantly migraine. Interventions Patients were randomly allocated to receive up to 12 acupuncture treatments over three  ...[more]

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