Physician and treatment characteristics a randomized multicentre trial of acupuncture inpatients with osteoarthritis of the knee

Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Humboldt University of Berlin, 10098 Berlin, Germany.
Complementary Therapies in Medicine (Impact Factor: 1.55). 10/2007; 15(3):180-9. DOI: 10.1016/j.ctim.2006.04.003
Source: PubMed


The aim of this paper is to describe the treatment and physician characteristics in a randomised trial of acupuncture for osteoarthritis of the knee.
Three-armed, randomised, controlled multicentre trial with 1-year follow-up.
Twenty-eight outpatient centres in Germany.
A total of 294 patients with osteoarthritis of the knee were randomised to 12 sessions of semi-standardised acupuncture (at least 6 local and 2 distant points needled per affected knee from a selection of predefined points, but individual choice of additional body or ear acupuncture points possible), 12 sessions of minimal acupuncture (superficial needling of at least 8 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list control (2 months no acupuncture).
Participating trial physicians and interventions.
Forty-seven physicians specialised in acupuncture (mean age 43+/-8 years, 26 females) provided study interventions in 28 outpatient centres in Germany. The median duration of acupuncture training completed by participating physicians was 350 h (range 140-2508). The total number of needles used was 17.4+/-4.8 in the acupuncture group compared to 12.9+/-3.3 in the minimal acupuncture group. In total, 39 physicians (83%) stated that they would have treated patients in either a similar or in exactly the same way outside of the trial, whereas 7 (15%) stated that they would have treated patients differently (1 missing).
Our documentation of the trial interventions shows that semi-standardised acupuncture strategy represents an acceptable compromise for efficacy studies. However, a substantial minority of participating trial physicians stated that they would have treated patients differently outside of the trial.

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    • "Since there are many adverse side effects of conventional western medication in treating OA [22], more and more OA patients use complementary and alternative medicine (CAM) to improve the symptoms and signs of the disease joints [23]. Chinese herbal medicine [24,25], acupuncture [26], dry cupping [27], herbal patch [28] or other CAM therapies [29] were the common CAM widely accepted by OA patients. "
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    ABSTRACT: Chinese herbal medicine (CHM) has been commonly used for treating osteoarthritis in Asia for centuries. This study aimed to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM used in treating osteoarthritis in Taiwan. A complete database (total 22,520,776 beneficiaries) of traditional Chinese medicine (TCM) outpatient claims offered by the National Health Insurance program in Taiwan for the year 2002 was employed for this research. Patients with osteoarthritis were identified according to the diagnostic code of the International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM for treating osteoarthritis. There were 20,059 subjects who visited TCM clinics for osteoarthritis and received a total of 32,050 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (19.2%), followed by 50-59 years (18.8%) and 60-69 years group (18.2%). In addition, female subjects used CHMs for osteoarthritis more frequently than male subjects (female: male = 1.89: l). There was an average of 5.2 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for osteoarthritis. Du-zhong (Eucommia bark) was the most commonly prescribed Chinese single herb, while Du-huo-ji-sheng-tang was the most commonly prescribed Chinese herbal formula for osteoarthritis. According to the association rule, the most commonly prescribed formula was Du-huo-ji-sheng-tang plus Shen-tong-zhu-yu-tang, and the most commonly prescribed triple-drug combination was Du-huo-ji-sheng-tang, Gu-sui-pu (Drynaria fortune (Kunze) J. Sm.), and Xu-Duan (Himalaya teasel). Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating osteoarthritis. This study conducted a large scale pharmaco-epidemiology survey of Chinese herbal medicine use in OA patients by analyzing the NHIRD in Taiwan in year 2002.
    BMC Complementary and Alternative Medicine 03/2014; 14(1):91. DOI:10.1186/1472-6882-14-91 · 2.02 Impact Factor
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    • "Since it is widely acknowledged that acupuncture is effective in relieving pain, there have been many studies on acupoint specificity with respect to migraine [6, 12, 26, 61, 72], fibromyalgia [14, 73, 74], lumbago [62, 75–77], osteoarthritis [1, 78, 79], and other painful diseases. These studies produced mixed results. "
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