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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

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Identify adverse events associated with
– Advice from acupuncturists to reduce or stop prescribed conventional medication – Delayed conventional diagnosis or treatment
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What we planned to do: a prospective patient survey


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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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Commonest significant events
1044 significant events reported by 682 patients

500
Number of events

400 300 200 100 0
e n n s ess pa i stio rain tom in u g p i le z xha rm tab /diz sym o p /e g ss cce e ss che nin in e a n a s e n d o rs du ro w ea d tir e d h w e ge e re e re e re ve r lon Se Pro Sev Sev Sev r the O

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Serious adverse events over three months


Three “serious” 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. Medication:
- 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
Significant adverse events Serious adverse events Medication related Delayed treatment Number patients reporting over 3 months / total 672 / 6348 3 / 6348 6 / 6348 2 / 6348 Rate per 1,000 patients over 3 months 107 0.4 1.0 0.3
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Relative risk for patients outside NHS
Adjusted odds ratio
Self-funded vs. paid for by national health service No GP contact vs. some GP contact 0.62 vs. 1.00

0.66 vs. 1.00

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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 low

Indirectly caused adverse events are infrequent
No evidence that patients outside NHS are at higher risk Despite adverse events, almost all willing to continue with acupuncture
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