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Sørensen RW, Andersen NI, Dieperink KB. NADA Acupuncture in Specialized Palliative Care: Patients' and Family Caregivers' Experiences. J Pain Symptom Manage 2024; 68:1-9. [PMID: 38522805 DOI: 10.1016/j.jpainsymman.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/27/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024]
Abstract
CONTEXT Over the last 30 years, non-pharmacological treatment with ear acupuncture, including National Acupuncture Detoxification Association (NADA) acupuncture, has become popular in Western society to relieve cancer-related symptoms. OBJECTIVES This study aim is to explore whether NADA acupuncture plays a role in relieving suffering experienced by patients hospitalized in a specialized palliative care ward and their family caregivers and whether it contributes to their coping skills. METHODS A qualitative study with a hermeneutic approach utilizing inductive thematic content analysis. Purposeful sampling took place in a specialized palliative care ward in Denmark and all data were collected through semi-structured interviews with patients and family caregivers as either individual or family interviews. RESULTS A total of 10 patients and 15 family caregivers participated in interviews. Four themes emerged: (1) communication about treatment with NADA acupuncture, (2) relief of suffering generates extra energy and inner strength, (3) sharing the experience with the family is beneficial, and (4) physical and psychological effects after receiving NADA acupuncture. CONCLUSION Patients in palliative care and their family caregivers experienced relief of suffering after receiving NADA acupuncture, as well as improved well-being, and extra energy and inner strength to cope with their life situation. The ability to share NADA acupuncture gave family caregivers the feeling of being cared for and contributed to feelings of fellowship and togetherness within the family, strengthening their ability to communicate and cope.
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Affiliation(s)
| | - Nina Ingerslev Andersen
- Department of Oncology (R.W.S., N.I.A., K.B.D.), Odense University Hospital, Odense, Denmark
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2
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Pujalte GGA, Malone M, Mandavalli A, Phrathep DD, Shah NP, Perlman AI. Acupuncture in Sports Medicine. J Acupunct Meridian Stud 2023; 16:239-247. [PMID: 38115589 DOI: 10.51507/j.jams.2023.16.6.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/23/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes' preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture's potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine.
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Affiliation(s)
- George G A Pujalte
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
- Department of Orthopedics and Sports Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Michael Malone
- Department of Family Medicine, Tidelands Health Family Medicine, Myrtle Beach, SC, USA
| | - Akhil Mandavalli
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Neil P Shah
- Family Medicine Residency Program, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Adam I Perlman
- Division of Integrative Medicine, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
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Azhar A, Hui D. Management of Physical Symptoms in Patients with Advanced Cancer During the Last Weeks and Days of Life. Cancer Res Treat 2022; 54:661-670. [PMID: 35790195 PMCID: PMC9296923 DOI: 10.4143/crt.2022.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Patients with advanced cancer are faced with many devastating symptoms in the last weeks and days of life, such as pain, delirium, dyspnea, bronchial hypersecretions (death rattle), and intractable seizures. Symptom management in the last weeks of life can be particularly challenging because of the high prevalence of delirium complicating symptom assessment, high symptom expression secondary to psychosocial and spiritual factors, limited life-expectancy requiring special considerations for prognosis-based decision-making, and distressed caregivers. There is a paucity of research involving patients in the last weeks of life, contributing to substantial variations in clinical practice. In this narrative review, we shall review the existing literature and provide a practical approach to in-patient management of several of the most distressing physical symptoms in the last weeks to days of life.
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4
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Zemel RA. Pharmacologic and Non-Pharmacologic Dyspnea Management in Advanced Cancer Patients. Am J Hosp Palliat Care 2021; 39:847-855. [PMID: 34510917 DOI: 10.1177/10499091211040436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
As there is a high propensity for patients with advanced malignancy to experience refractory dyspnea, it is necessary for physicians to be well-versed in the management of these patients' dyspneic symptoms. For symptomatic treatment of cancer patients with dyspnea, both pharmacologic and non-pharmacologic methods should be considered. The main source of pharmacologic symptom management for dyspnea is oral and parenteral opioids; benzodiazepines and corticosteroids may serve as helpful adjuncts alongside opioid treatments. However, oxygen administration and nebulized loop diuretics have not been shown to clinically benefit dyspneic cancer patients. Applying non-pharmacologic dyspnea management methods may be valuable palliative therapies for advanced cancer patients, as they provide benefit with negligible harm to the patient. Advantageous and minimally harmful non-pharmacologic dyspnea therapies include facial airflow, acupuncture and/or acupressure, breathing exercises, cognitive behavioral therapy, music therapy, and spiritual interventions. Thus, it is vital that physicians are prepared to provide symptomatic care for dyspnea in advanced cancer patients as to minimize suffering in this patient population during definitive cancer treatments or hospice care.
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Affiliation(s)
- Rachel A Zemel
- MedStar Georgetown University Hospital, Brookeville, MD, USA
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Luh C, Eckstrom E. Perceptions That Influence Acupuncture Use in Hospice Settings: Results of a State-Wide Survey Study. J Altern Complement Med 2021; 27:760-770. [PMID: 34129378 DOI: 10.1089/acm.2021.0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Acupuncture is an effective and low-risk therapy for a wide spectrum of medical conditions. In the hospice setting, where comfort is the top priority, acupuncture could play a vital role in reducing symptom burden at the end of life. Objective: This state-wide survey study explored perceived barriers to acupuncture use in the hospice setting from acupuncturist and hospice staff perspectives. Specific barriers addressed included insurance coverage/funding for acupuncture, lack of knowledge of acupuncture as a therapeutic modality, and perceived insufficient evidence base for acupuncture. Materials and Methods: Acupuncturists and hospice staff in Oregon were recruited by e-mail and/or telephone to complete their survey. Results: Among acupuncturists, a response rate of 50% was obtained. The response rate of hospice staff could not be obtained. There were a total of 270 providers and hospice staff (102 acupuncturists, 16 hospice doctors, 14 hospice directors, 93 hospice nurses, 30 hospice social workers, and 15 hospice chaplains). The majority of acupuncturists (76% and 89%, respectively) and hospice staff (59% and 82%, respectively) strongly agreed or somewhat agreed that insurance coverage/funding for acupuncture and lack of knowledge of acupuncture as a therapeutic modality are important barriers. With respect to the perceived evidence base for acupuncture, the majority of acupuncturists (91%) and hospice staff (69%) strongly agreed or somewhat agreed that acupuncture can help provide a higher quality of life for hospice patients, although knowledge of specific conditions amenable to acupuncture among acupuncturists and hospice staff varied. Conclusions: From the acupuncturist and hospice staff perspectives, insurance coverage/funding for acupuncture, lack of knowledge of acupuncture as a therapeutic modality, and perceived insufficient evidence base for acupuncture are primary barriers to the use of acupuncture in hospice care. Increased awareness/education about acupuncture in the hospice setting, as well as improved funding structures, is critical.
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Affiliation(s)
- Colin Luh
- OHSU School of Medicine, Portland, OR, USA
| | - Elizabeth Eckstrom
- OHSU Division of General Internal Medicine and Geriatrics, Portland, OR, USA
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Baker K, McDonald J, Steel A. Tackling health inequity: a commentary on the potential of acupuncture to improve health outcomes of marginalised populations. Acupunct Med 2020; 39:533-537. [PMID: 33280395 DOI: 10.1177/0964528420961404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society's marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage. DISCUSSION Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups. CONCLUSION Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
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Affiliation(s)
- Kirsten Baker
- Endeavour College of Natural Health, Brisbane, QLD, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - John McDonald
- Griffith University School of Medicine, Gold Coast, QLD, Australia
| | - Amie Steel
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Birch S, Bovey M, Alraek T, Robinson N, Kim TH, Lee MS. Acupuncture as a Treatment Within Integrative Health for Palliative Care: A Brief Narrative Review of Evidence and Recommendations. J Altern Complement Med 2020; 26:784-791. [PMID: 32924554 DOI: 10.1089/acm.2020.0032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Acupuncture is one of the fastest developing evidence bases in Complementary Medicine and is one of the leading therapies included within integrative health care. This narrative review includes two separate parts: the first is about evaluation of the current evidence status in reviews on acupuncture and the second examines and gives examples of available recommendations on acupuncture in treatment guidelines from health care experts and public health organizations recommending acupuncture as a viable treatment in patients in palliative care. Methods: Electronic searches were performed in PubMed using the terms "acupuncture" + "palliative" and adding the term "safety" to find review articles documenting safety and evidence of effectiveness of acupuncture for treatment of symptoms in palliative care patients. Treatment guidelines that recommend use of acupuncture for symptom control in palliative care were found by searching through a database currently under construction by the lead author. Results: Acupuncture shows emerging evidence for 17 indications in palliative care. Examples were found and presented of publications recommending acupuncture for treatment of symptoms for patients in palliative care from Government, public health, oncology, and medical expert sources. The most publications are in oncology, but other conditions were found and a number were found in pediatric care. Conclusions: While the evidence for use of acupuncture to treat symptoms in palliative care patients is relatively weak, the evidence base is growing. Experts worldwide are also increasingly recommending acupuncture as a treatment for symptoms in palliative care. Since acupuncture is a safe, nonpharmacological treatment but with small, clinically significant effects, these recommended uses appear as pragmatic efforts to bridge the gap of treatment options available to this patient group.
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Affiliation(s)
- Stephen Birch
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Mark Bovey
- British Acupuncture Council, Acupuncture Research Resource Center, London, United Kingdom
| | - Terje Alraek
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Community Medicine, Faculty of Medicine, National Research Center in Complementary and Alternative Medicine, UiT the Arctic University of Norway, Tromso, Norway
| | - Nicola Robinson
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- Division of Clinical Medicine, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Arentz S, Hunter J, Deed G. Integrating Traditional and Complementary Medicine Recommendations into Clinical Practice Guidelines for People with Diabetes in Need of Palliative and End-of-Life Care: A Scoping Review. J Altern Complement Med 2020; 26:571-591. [PMID: 32673080 DOI: 10.1089/acm.2020.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: This study was conducted before an evidence review on Traditional and Complementary Medicine (TCM) to update the clinical practice guidelines (CPGs): "Deciding palliative and end-of-life (P/EoL) care for people with diabetes." The aim was to frame the PICO (population/problems, interventions/comparisons, and outcomes), ascertain their importance, and identify other modifying factors for grading recommendations. Design: A systematic scoping review mapped information about diabetes P/EoL problems and outcomes, TCM use, provision, benefits and risks, and stakeholder preferences and values. Thirteen electronic databases were searched in 2017/18 until no new information was identified. Relevant data were extracted, rated for quality, directness, and relevance, and synthesized using triangulation methods. Excluded was diabetes prevention or treatment, as this is not an important P/EoL problem. Results: Of the 228 included articles, except for diabetes P/EoL problems, insufficient direct evidence led to data being extrapolated from either adults with diabetes or any P/EoL diagnosis. The findings affirmed that caring for people with diabetes in need of P/EoL care is complex due to multiple fluctuating needs that are influenced by the P/EoL trajectories (stable, unstable, deteriorating, terminal, or bereaved), multimorbidity, and difficult-to-manage chronic and acute problems. The only problem specific to diabetes P/EoL care, was unstable glycemia. Over 50 TCM interventions commonly used by patients and/or provided by services were identified, of which, many might simultaneously address multiple problems and 18 had been appraised in systematic reviews. Physical and psychologic symptom reliefs were most often evaluated; however, these were only one aspect of a "good death." Other important outcomes were the quality and location of care, personal agency, relationships, preparations for the dying process, spirituality, and affirmation of the whole person. Other important modifying factors included opportunity costs, affordability, availability, preferences, cultural appropriateness, and alignment with beliefs about the meaning of illness and death. Conclusions: There is a role for TCM in the multidisciplinary holistic P/EoL care of people with diabetes. Due to the paucity of evidence specific to this population, the generalizability of some of these results is broader and the updated CPG will also need to consider indirect evidence from other patient groups. Along with recommendations about indications for TCM use, the CGP should provide guidance on ceasing unnecessary interventions, reducing polypharmacy and managing unstable glycemia is required. Before ceasing a TCM, a broader risk-benefit analysis is recommended, as unlike many conventional therapies, there may be multiple benefits warranting its continuation.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Gary Deed
- Metabolism Ageing Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Giannitrapani KF, Ahluwalia SC, McCaa M, Pisciotta M, Dobscha S, Lorenz KA. Barriers to Using Nonpharmacologic Approaches and Reducing Opioid Use in Primary Care. PAIN MEDICINE 2020; 19:1357-1364. [PMID: 29059412 DOI: 10.1093/pm/pnx220] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Opioid prescribing for chronic pain, including the potential for over-reliance and misuse, is a public health concern. OBJECTIVE In the context of Veterans Administration (VA) primary care team-based pain management, we aimed to understand providers' perceptions of barriers to reducing opioid use and improving the use of nonpharmacologic pain management therapies (NPTs) for chronic pain. DESIGN A semistructured interview elucidated provider experiences with assessing and managing pain. Emergent themes were mapped to known dimensions of VA primary care access. SUBJECTS Informants included 60 primary care providers, registered nurses, licensed practical nurses, clerks, psychologists, and social workers at two VA Medical Centers. METHODS Nine multidisciplinary focus groups. RESULTS Provider perceptions of barriers to reducing opioids and improving use of NPTs for patients with chronic pain clustered around availability and access. Barriers to NPT access included the following subthemes: geographical (patient distance from service), financial (out-of-pocket cost to patient), temporal (treatment time delays), cultural (belief that NPTs increased provider workload, perception of insufficient training on NPTs, perceptions of patient resistance to change, confrontation avoidance, and insufficient leadership support), and digital (measure used for pain assessment, older patients hesitant to use technology, providers overwhelmed by information). CONCLUSIONS Decreasing reliance on opioids for chronic pain requires a commitment to local availability and provider-facing strategies that increase efficacy in prescribing NPTs. Policies and interventions for decreasing utilization of opioids and increasing use of NPTs should comprehensively consider access barriers.
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Affiliation(s)
- Karleen F Giannitrapani
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Sangeeta C Ahluwalia
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA.,The RAND Corporation, Santa Monica, California, USA
| | - Matthew McCaa
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Maura Pisciotta
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA
| | - Steven Dobscha
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA.,Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Karl A Lorenz
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA.,The RAND Corporation, Santa Monica, California, USA.,Stanford School of Medicine, Stanford, California, USA
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Abstract
Purpose The aim of the present work was to evaluate the availability of acupuncture in UK hospices and specialist palliative care services and to identify any barriers to the use of acupuncture in these settings, to determine the characteristics of available acupuncture services and of practitioners providing acupuncture, and to determine awareness of the evidence base for the use of acupuncture in palliative care. Methods An online questionnaire with an invitation to participate was circulated by email to 263 hospices and specialist palliative care services in the UK. Results A response rate of 54% was obtained. Acupuncture was provided by 59% of services that responded. In general, small numbers of patients receive acupuncture as part of their palliative care treatment as inpatients, day patients or outpatients. Most practitioners were regulated health professionals who had received a Western-style training in acupuncture and used a Western-style medical acupuncture approach. Where acupuncture was not available the commonest reason given was the lack of a suitable practitioner. Most agreed that if funding and a suitable practitioner were available, acupuncture would be a useful addition to their service. The level of awareness of specific types of evidence supporting the use of acupuncture in palliative care was low, but most respondents were aware that some evidence existed. Conclusions There is a need to increase training in acupuncture for healthcare professionals working in palliative care. There is also a need to raise awareness of the potential benefits to patients and the evidence base supporting the use of acupuncture in palliative care.
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Birch S, Lee MS, Alraek T, Kim TH. Overview of Treatment Guidelines and Clinical Practical Guidelines That Recommend the Use of Acupuncture: A Bibliometric Analysis. J Altern Complement Med 2018; 24:752-769. [PMID: 29912569 DOI: 10.1089/acm.2018.0092] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION As positive evidence emerges for the use of an intervention to treat a health problem, the intervention gradually becomes incorporated into treatment guidelines (TGs) or clinical practice guidelines (CPGs) that are related to that health problem. To assess whether this general hypothesis can apply to acupuncture, 96 health problems were identified for which positive conclusions in systematic reviews and meta-analyses regarding the effectiveness of acupuncture have been made and then searched for TGs or CPGs that have recommended the use of acupuncture. METHODS Through August 31, 2017, searches were performed in relevant medical databases and Google using "treatment guideline," "clinical practice guideline," and the names of the 96 medical conditions as search terms. A "snow-balling" search approach was adopted. All positive recommendations were added into the registry. RESULTS A total of 1311 publications were found that recommended using acupuncture published between 1991 and 2017. The number per year reached 50 in 2005 and 100 in 2009. In addition, 2189 positive recommendations were found for the use of acupuncture. Of these, 1486 were related to 107 pain indications and 703 were related to 97 nonpain indications. These recommendations were made by a wide range of groups, such as government health institutions, national guideline, and medical specialty groups. The recommendations came from around the world but were especially abundant in North America, Europe, and Australasia. DISCUSSION AND CONCLUSION Considerably more recommendations were found for the use of acupuncture than are known within the acupuncture or medical communities. A trend by year was also found; a rise in the number of positive statements about acupuncture was typically followed by a rise in the number of recommendations of acupuncture. Thus, the recommendations followed the emergent evidence for acupuncture. Better implementation plans need to be developed for the CPG/TG recommendations about acupuncture to be more effective/efficient.
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Affiliation(s)
- Stephen Birch
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway
| | - Myeong Soo Lee
- 2 Clinical Medicine Division, Korea Institute of Oriental Medicine , Daejeon, Republic of South Korea
| | - Terje Alraek
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway .,3 Department of Community Medicine, Faculty of Medicine, National Research Centre in Complementary and Alternative Medicine, UiT The Arctic University of Norway , Tromso, Norway
| | - Tae-Hun Kim
- 4 Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University , Seoul, Republic of Korea
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McPhail P, Sandhu H, Dale J, Stewart-Brown S. Acupuncture in hospice settings: A qualitative exploration of patients' experiences. Eur J Cancer Care (Engl) 2018; 27:e12802. [PMID: 29323766 DOI: 10.1111/ecc.12802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/28/2022]
Abstract
Whilst acupuncture has the potential to impact on many aspects of health and well-being, including end-of-life care, there is little research regarding patients' experiences of its effects within the context of palliative care in hospice settings. The aim of this study was to address this gap, by exploring patients' experiences of acupuncture within this setting. In-depth, semi-structured interviews were conducted with a sample of eighteen patients who had received acupuncture as part of hospice care. Transcription of data, with thematic analysis, identified two overarching themes: (1) participant perceptions of the effects of acupuncture including pain control, improved physical and emotional health, spiritual well-being and awareness of health as a holistic phenomenon; and (2) factors which participants believed enabled acupuncture to have these effects including the quality of the practitioner relationship, engagement of participants in the process of their treatment and prior expectations that acupuncture could work. Acupuncture was found to be a highly acceptable, accessible and popular treatment with positive holistic effects reported across the domains of physical, mental and spiritual health and no serious adverse effects. By enabling awareness of the holistic nature of health and well-being, acupuncture was experienced as having the potential to contribute to a better death, an emergent theory that needs testing in further studies. In the meanwhile, the results of this study offer encouragement to hospices currently providing or considering investing in acupuncture provision.
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Affiliation(s)
- P McPhail
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Sandhu
- Division of Health Sciences, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - J Dale
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Kramer S, Irnich D, Lorenzl S. Acupuncture for Symptom Relief in Palliative Care-Study Protocol and Semistandardized Treatment Schemes. J Acupunct Meridian Stud 2017; 10:294-302. [PMID: 28889847 DOI: 10.1016/j.jams.2017.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/06/2017] [Accepted: 04/18/2017] [Indexed: 11/27/2022] Open
Abstract
The use of complementary and alternative medicine methods such as acupuncture in palliative care has increased over the past years. Well-planned trials are warranted to show its effectiveness in relieving distressing symptoms. The development of treatment schemes to be used in the trial for both acupuncture and medical symptom control is challenging, as both acupuncture and palliative care are highly individualized. Thus, standardized care plans of a randomized controlled trial will have difficulties in producing treatment results that compare to the clinical practice. As an alternative, treatment protocols for both acupuncture and medical symptom control of dyspnea, pruritus, hypersalivation, depression, anxiety, and xerostomia were designed with the input of experts. They are designed to provide sufficient symptom control and comparability for a three-arm, randomized controlled trial. Medical symptom control will be provided to all groups. The two control groups will be medical treatment and sham-laser acupuncture.
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Affiliation(s)
- Sybille Kramer
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich, Munich, Germany.
| | - Dominik Irnich
- Multidisciplinary Pain Centre, Department of Anesthesiology, University of Munich, Munich, Germany
| | - Stefan Lorenzl
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria; Clinic and Policlinic for Palliative Care, Klinikum der Universität München, Ludwig Maximilians University, Munich, Germany
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Oh B, Eade T, Kneebone A, Pavlakis N, Clarke S, Eslick G, River J, Back M. Factors Affecting Whether Or Not Cancer Patients Consider Using Acupuncture. Acupunct Med 2017; 35:107-113. [DOI: 10.1136/acupmed-2016-011115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 11/04/2022]
Abstract
Objective To explore the factors associated with utilisation of an acupuncture service in a tertiary oncology setting in an Australian public hospital. Method Cancer patients attending oncology clinics at a university teaching hospital were invited to participate in the evaluation of acupuncture services from June 2014 to May 2015. Patients had a prior diagnosis of cancer (albeit at different stages) and were planning to receive, or were already receiving, systemic and/or radiation cancer treatment. Results The majority (81%) of participants indicated that they would consider the use of acupuncture during their cancer treatment. The most common reasons given for not considering acupuncture included adequate control of symptoms already with medical treatment, inconvenient clinic timing, and needle phobia. The main reasons given for considering acupuncture use included its perceived capability of reducing fatigue, boosting energy levels, improving immune function, and reducing pain and anxiety. Patients considering acupuncture use also demonstrated significantly higher levels of stress (p<0.001), anxiety and depression (p<0.001), fatigue (p<0.001), and lower global quality of life (p<0.01) compared to those who were not considering acupuncture. Conclusions The findings show that demand for acupuncture by cancer patients is high. A substantial proportion of cancer patients intend to use acupuncture to manage cancer and/or cancer treatment-related symptoms. Discussion with patients about acupuncture and other complementary therapies during the consultation may improve cancer care.
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Affiliation(s)
- Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas Eade
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Kneebone
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Nick Pavlakis
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Clarke
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Guy Eslick
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jo River
- Sydney Nursing School, University of Sydney, Camperdown, New South Wales, Australia
| | - Michael Back
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Mallory MJ, Do A, Bublitz SE, Veleber SJ, Bauer BA, Bhagra A. Puncturing the myths of acupuncture. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:311-4. [PMID: 27641603 DOI: 10.1016/s2095-4964(16)60269-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acupuncture is a widely practiced system of medicine that has been in place for thousands of years. Consumer interest and use of acupuncture are becoming increasingly popular in the United States, as it is used to treat a multitude of symptoms and disease processes as well as to maintain health and prevent illness. A growing body of evidence increasingly validates the practice of acupuncture. Further developing scientific data will play an important role in the future of acupuncture and other complementary and alternative medicines in public health. Acupuncture is commonly used concurrently with conventional medicine. Although acupuncture is embraced by consumers and medical professionals, misconceptions abound. We have explored and dispelled ten misconceptions common to the practice of acupuncture, utilizing an evidence-based approach. As the trend of merging conventional medical care with acupuncture treatment grows, it is important to develop a conceptual model of integrative medicine. Using a scientific evidence approach will create a structure from which to begin and grow confidence among conventional medical providers. Acupuncture is a safe and effective modality when performed properly by trained professionals. Educating both the consumer and medical community is important to enable appropriate and evidence-based applications of acupuncture and integration with conventional medicine for high-quality patient care.
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Affiliation(s)
- Molly J Mallory
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Alexander Do
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Sara E Bublitz
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Susan J Veleber
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Brent A Bauer
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Anjali Bhagra
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Work environment facilitators to the availability of complementary and alternative therapies in perinatal hospices. J Hosp Palliat Nurs 2015; 17:391-396. [PMID: 26877713 DOI: 10.1097/njh.0000000000000167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increasingly, patients and clinicians are considering palliative care interventions during pregnancy for the maternal-fetal dyad, when a life-limiting diagnosis is confirmed. Nurses are at the forefront of providing hospice and palliative care that includes planning interventions for infants nearing the end of life. However, little is known about the work environment facilitators to the availability of complementary and alternative medicine (CAM) therapies. Using a national database of perinatal hospice and palliative care providers, we described the types of CAM therapies available and explored the influence of the nurse work environment on the availability of CAM therapies with multivariate regression analysis. This study showed that having an education environment where clinicians are trained, along with a highly educated RN support staff, and a BSN educated staff were critical to the availability of CAM therapies. The clinical implications for hospice and palliative nurses caring for infants and their families were discussed.
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Romeo MJ, Parton B, Russo RA, Hays LS, Conboy L. Acupuncture to Treat the Symptoms of Patients in a Palliative Care Setting. Explore (NY) 2015; 11:357-62. [DOI: 10.1016/j.explore.2015.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Indexed: 12/15/2022]
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Yoon S, Grundmann O, Williams J, Carriere G. Novel Intervention With Acupuncture for Anorexia and Cachexia in Patients With Gastrointestinal Tract Cancers: A Feasibility Study. Oncol Nurs Forum 2015; 42:E102-9. [DOI: 10.1188/15.onf.e102-e109] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tas D, Uncu D, Sendur MA, Koca N, Zengin N. Acupuncture as a Complementary Treatment for Cancer Patients Receiving Chemotherapy. Asian Pac J Cancer Prev 2014; 15:3139-44. [DOI: 10.7314/apjcp.2014.15.7.3139] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lian WL, Pan MQ, Zhou DH, Zhang ZJ. Effectiveness of acupuncture for palliative care in cancer patients: A systematic review. Chin J Integr Med 2013; 20:136-47. [DOI: 10.1007/s11655-013-1439-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Indexed: 11/25/2022]
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A Survey of the Use of Complementary and Alternative Medicine in Illinois Hospice and Palliative Care Organizations. Am J Hosp Palliat Care 2013; 31:553-61. [DOI: 10.1177/1049909113500378] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This research assesses complementary and alternative medicine (CAM) use and administration for patients and family caregivers in Illinois hospice and palliative care organizations. An online survey was administered to a sample of 108 contacts of Illinois organizations listed in the National Hospice and Palliative Care Organization website, and 90.3% of the responding organizations offered some type of CAM. The top 5 most frequently offered CAM modalities to patients were pet therapy (64.5%), music therapy (61.3%), massage therapy (54.8%), art therapy (29.0%), and energy therapies (25.8%); these were the same top 5 offered to families but with different frequencies. Findings regarding utilization, administration, financing, and spiritual/cultural competency are discussed with policy recommendations for data collection, administrative improvements, and integration of CAM providers into service delivery.
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Towler P, Molassiotis A, Brearley SG. What is the evidence for the use of acupuncture as an intervention for symptom management in cancer supportive and palliative care: an integrative overview of reviews. Support Care Cancer 2013; 21:2913-23. [DOI: 10.1007/s00520-013-1882-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 06/19/2013] [Indexed: 11/29/2022]
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Kasymjanova G, Grossman M, Tran T, Jagoe RT, Cohen V, Pepe C, Small D, Agulnik J. The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study. ACTA ACUST UNITED AC 2013; 20:152-7. [PMID: 23737683 DOI: 10.3747/co.20.1312] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most lung cancer patients experience multiple symptoms related either to the disease or its treatment. The commonly reported symptoms are pain, depression, anxiety, nausea, and poor well-being. The aim of the present study was to evaluate the effect of acupuncture as a potential treatment modality in symptomatic lung cancer patients. METHODS This prospective observational study enrolled 33 lung cancer patients from the Peter Brojde Lung Cancer Centre between August 2010 and May 2012. All patients received 45-minute sessions of acupuncture, 1-2 times weekly for a minimum of 4 sessions. Symptom severity was assessed using the Edmonton Symptom Assessment System (esas) before and after completion of acupuncture. RESULTS The study cohort included 30 patients with non-small- cell lung cancer and 3 with small-cell lung cancer. Mean age was 62 years (range: 36-88 years); 17 of the patients were women. Most of the patients had advanced-stage cancer (73%) and good performance status (Eastern Cooperative Oncology Group 0-1: 88%). Of these patients, 67% received anticancer treatment (chemotherapy or radiotherapy, or both) with acupuncture. Of the remaining 10 patients, 8 received acupuncture after a complete surgical resection of their tumour, and because of their advanced age, 2 received acupuncture and best supportive care. The median number of acupuncture sessions was 7 (interquartile range: 4-13 sessions). Statistically significant improvements in pain, appetite, nausea, nervousness, and well-being were observed. A clinically important improvement (2 points on the esas) was reported by 61% of patients for pain and by 33% for well-being. A significant positive correlation between improved well-being and the number of acupuncture sessions was observed. This correlation remained significant even after controlling for treatment and narcotic use. Receiver operating characteristic analysis demonstrated that a minimum of 6 acupuncture sessions are required for a 70% chance of a clinically important improvement in well-being. CONCLUSIONS The present study is the first to demonstrate that acupuncture may be an effective approach for improving symptoms-in particular, pain and well-being-in lung cancer patients. Acupuncture is a safe and minimally invasive procedure, and it is potentially useful even in patients undergoing anticancer treatment.
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Affiliation(s)
- G Kasymjanova
- Peter Brojde Lung Cancer Centre, Montreal, QC. ; Jewish General Hospital, Montreal, QC
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Olotu BS, Brown CM, Barner JC, Lawson KA. Factors associated with hospices' provision of complementary and alternative medicine. Am J Hosp Palliat Care 2013; 31:385-91. [PMID: 23689364 DOI: 10.1177/1049909113489873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is limited research about the provision of complementary and alternative (CAM) in US hospices. The purpose of this study was to assess the factors that influence hospices' likelihood of providing CAM therapies. Mail surveys were sent to 369 hospices in Texas; 61 were returned undelivered, yielding a total usable response rate of 35.7% (n = 110) after an initial and one follow-up mail out. Binary logistic regression was used to assess whether the likelihood of offering CAM is related to hospice's age, geographic location, agency type, profit orientation, Medicare certification, and number of patients served annually. Results showed that profit orientation and the number of patients served by hospices were significantly related to the probability that hospices will offer CAM. Specifically, the odds of offering CAM in not-for-profit hospices were approximately 4 times higher than that in for-profit hospices (odds ratio [OR] = 3.77, P = .022, 95% confidence interval [CI] = 1.2, 11.8). In addition, for every 100 patients served by the hospices, the odds of offering CAM increases by 13% (OR = 1.13, P = .015, 95% CI = 1.02, 1.25). In conclusion, CAM offering by hospices is related to hospices' profit orientation status and number of patients served but is not related to other measured characteristics of hospices.
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Affiliation(s)
- Busuyi S Olotu
- 1Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
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Saw CLL, Chew L, Goh C. Recent Non-Interventional Advances in Cancer Pain Among Singapore Patients. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n9p407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Pain is a common symptom in cancer patients, but very little information about the prevalence, severity, and treatment of pain in cancer patients in Singapore is available. Therefore, our prospective survey in the National Cancer Centre (NCC) outpatients is incorporated in this report. In addition, a review concerning the recent advances on non-interventional pain management in cancer treatment, which is relevant in the context, is discussed. Materials and Methods: For the prospective survey, a questionnaire was distributed for self-administration by patients while waiting for consultation at the NCC outpatient departments. Literature searches on advances in pain management were conducted, reviewed and discussed. Results: In the last decade, there have been advances in pain pharmacology ranging from wider therapeutic options and management approaches to novel delivery techniques. Acupuncture and massage therapy became increasingly popular among cancer patients. Some clinical trials of acupuncture show benefits in palliation of cancer pain. From the prospective survey, 41.2% of the responders reported pain in the past week, and only 70.8% talked to their doctors about their pain. One third of the patients received analgesics. Of these, 86.5% said that they were taking the prescribed medications, however, 37.4% admitted to having difficulties taking them. Non-drug methods were used by 25.4% of the patients. Medicated oil, cream or gel was used by 49.3%; only 2.6% reported use of Chinese herbs. Conclusion: Pain is a significant symptom in outpatients attending a cancer centre, affecting 41.2% of the patients. Although majority of patients who suffered from pain reported this to doctors, much more medical effort is needed to help patients to relieve their pain and proper complementary therapy could be considered.
Key words: Cancer outpatients, Complementary therapies, Non-pharmacological pain treatments, Pain prevalence
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Standish LJ, Sweet E, Naydis E, Andersen MR. Can we demonstrate that breast cancer "integrative oncology" is effective? A methodology to evaluate the effectiveness of integrative oncology offered in community clinics. Integr Cancer Ther 2012; 12:126-35. [PMID: 22740079 DOI: 10.1177/1534735412447582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Many women diagnosed with breast cancer receive both standard cancer treatment and care from providers trained in the emerging field of medicine called integrative oncology (IO) in which science-based complementary and alternative medical therapies are prescribed by physicians. The effectiveness of IO services has not been fully studied, so is yet unknown. PURPOSE Determine if a matched, case-controlled prospective outcomes study evaluating the efficacy and safety of breast cancer IO care is feasible. METHODS Methodological proof of principle requires demonstration that (1) it is possible to find matched control breast cancer patients using the Surveillance, Epidemiology and End RESULTS Results. A pilot study was conducted in 2008 (n = 14) to determine if matched controlled women could be identified in the western Washington SEER database. All 14 women who were approached agreed to participate. The cases were matched to the CSS along 5 variables: age and stage at diagnosis, race, and marital and Estrogen Receptors/Progesterone Receptors (ER/PR) status. Multiple matches were found for 12 of the 14 participants. CONCLUSION A prospective cohort study with a matched comparison group is a feasible and potentially rigorous STUDY DESIGN It may provide valuable data for the evaluation of the effectiveness of IO care on patient health, relapse rate, and health-related quality of life (HRQOL). A federally funded matched case controlled outcomes study is currently under way at Bastyr University and the Fred Hutchinson Cancer Research Center.
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Affiliation(s)
- Leanna J Standish
- Bastyr Integrative Oncology Research Center, Bastyr University, 14500 Juanita Dr NE, Kenmore, WA 98028, USA.
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Beith JM, Oh B, Hale AK, Venkateswaran R. Acupuncture Use in Women with Breast Cancer. Med Acupunct 2011. [DOI: 10.1089/acu.2011.0798] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Jane M. Beith
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Byeongsang Oh
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda K. Hale
- Sydney Cancer Centre, Concord Hospital, Sydney, New South Wales, Australia
| | - Ramya Venkateswaran
- Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Kim KH, Kim TH, Kang JW, Sul JU, Lee MS, Kim JI, Shin MS, Jung SY, Kim AR, Kang KW, Choi SM. Acupuncture for symptom management in hemodialysis patients: a prospective, observational pilot study. J Altern Complement Med 2011; 17:741-8. [PMID: 21721925 DOI: 10.1089/acm.2010.0206] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Patients undergoing hemodialysis suffer from a variety of complications related to end-stage renal disease. This prospective, observational pilot study aims to determine the feasibility, safety, and possible benefits of acupuncture for symptom management in patients undergoing hemodialysis. METHODS Twenty-four (24) patients undergoing hemodialysis received acupuncture treatment for their symptoms. Manually stimulated, individualized acupuncture treatments were provided twice a week for 6 consecutive weeks on a nondialysis day or on the day of hemodialysis prior to initiating treatment. Symptoms were evaluated using the Measure Your Medical Outcome Profiles 2 questionnaire, and quality of life was measured by Kidney Disease Quality of Life-Short Form (KDQOL-SF(™)) Version 1.3 at baseline, 7 weeks and 11 weeks from baseline. Statistical analysis was conducted on the basis of the intention-to-treat principle. RESULTS Twenty-one (21) patients (87%) completed the whole treatment course and follow-up evaluation. Three (3) patients dropped out due to increased fatigue (n = 1), pancreatic and renal transplantation (n = 1), and infections of the arteriovenous fistula used for hemodialysis access (n = 1). Patients experienced a significant improvement of symptoms considered the most bothersome, reporting a decrease of 1.87 and 2.08 points on a 0-6 symptom scale at 7 weeks and 11 weeks, respectively (both p < 0.0001). Some subscales of KDQOL-SF(™) showed significant improvement at 7 weeks (effects of kidney disease, burden of kidney disease, role-limitations physical, emotional well-being, and energy/fatigue) and 11 weeks (physical functioning and energy/fatigue). No serious adverse events related to acupuncture occurred. CONCLUSIONS Acupuncture seems feasible and safe for symptom management in patients undergoing hemodialysis. Future controlled trials are needed to confirm the benefits of acupuncture.
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Affiliation(s)
- Kun Hyung Kim
- Acupuncture, Moxibustion & Meridian Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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O'Regan D, Filshie J. Acupuncture and cancer. Auton Neurosci 2010; 157:96-100. [DOI: 10.1016/j.autneu.2010.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Revised: 04/13/2010] [Accepted: 05/01/2010] [Indexed: 10/19/2022]
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Dean-Clower E, Doherty-Gilman AM, Keshaviah A, Baker F, Kaw C, Weidong Lu, Manola J, Penson RT, Matulonis UA, Rosenthal DS. Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients. Integr Cancer Ther 2010; 9:158-67. [DOI: 10.1177/1534735409360666] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL). Methods. This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session. A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points. Results. Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain, and depression and significant improvement over time for patients with anxiety ( P = .001) and depression ( P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety ( P = .001), fatigue ( P = .0002), pain ( P = .0002), and depression ( P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks. Conclusions. This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.
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Affiliation(s)
- Elizabeth Dean-Clower
- Dana-Farber Cancer Institute, Boston, MA, USA, Harvard Medical School, Boston, MA, USA
| | | | | | - Frank Baker
- Center for Medical Outcomes Research, School of Health Sciences & Practice, New York Medical College, Valhalla, NY, USA
| | | | - Weidong Lu
- Dana-Farber Cancer Institute, Boston, MA, USA, Harvard Medical School, Boston, MA, USA
| | | | - Richard T. Penson
- Massachusetts General Hospital, Boston, MA, USA, Harvard Medical School, Boston, MA, USA
| | - Ursula A. Matulonis
- Dana-Farber Cancer Institute, Boston, MA, USA, Harvard Medical School, Boston, MA, USA
| | - David S. Rosenthal
- Dana-Farber Cancer Institute, Boston, MA, USA, Harvard Medical School, Boston, MA, USA,
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A call for simple and rational palliative medicine psychotropic prescribing guidelines: Response to Barnhorst et al. ( Palliative & Supportive Care, Volume 6, Number 1, 2008). Palliat Support Care 2009; 7:3-6. [DOI: 10.1017/s1478951509000029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bibliography. PROGRESS IN PALLIATIVE CARE 2009. [DOI: 10.1179/096992609x392222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Rousseau PC. Recent Literature. J Palliat Med 2009. [DOI: 10.1089/jpm.2009.9683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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