Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
Eur J Pain. 2011 Feb;15(2):193-7. doi: 10.1016/j.ejpain.2010.06.008. Epub 2010 Jul 6.
The aim was to investigate the frequency of adverse effects due to acupuncture treatment, the need for treatment and the costs in patients with chronic low back or neck pain. This prospective observational study included patients who received acupuncture for chronic low back pain or chronic neck pain. After treatment all patients documented adverse events associated with acupuncture (defined as adverse effects) and provided details e.g. on treatment. Cost data was provided by the health insurance companies. We used a societal perspective including direct health care costs related to the acupuncture and the indirect costs caused through lost workdays. From 73,406 patients, 5440 patients (7.4% [95% CI 7.2%; 7.6%] reported experiencing at least one adverse effect and 1422 patients (1.9% [1.8%; 2.0%]) required treatment. The subsequent treatments reported were either self-treatment (1.2% [1.09%; 1.25%]), treatment with medication and/or by a physician (0.6% [0.57%; 0.68%]), or treatment in a hospital (0.03% [0.02%; 0.04%]). Patients reporting adverse effects that required treatment had higher costs compared to patients without adverse effects (at 3months €1265 [1179; 1351] vs. €1140 [1128; 1153] and at 12months € 3534 [3256; 3812] vs. € 3249 [3209; 3289]. The difference was caused through the expense of visiting physicians and higher indirect costs (difference at 3months: €125 [38; 211], p=0.005 and at 12months: €285 [4; 566], p=0.047). Adverse effects from acupuncture occur in about 7% of patients and were mainly treated by themselves. When these effects needed treatment by a health professional additional expenses were the consequence.
目的在于探究慢性腰或颈痛患者接受针灸治疗后出现的不良反应发生率、治疗需求和费用情况。本前瞻性观察研究纳入了接受慢性腰痛或慢性颈痛针灸治疗的患者。治疗后，所有患者均记录了与针灸相关的不良事件（定义为不良反应），并提供了治疗详情等信息。费用数据由健康保险公司提供。我们采用了包括与针灸相关的直接医疗费用和因旷工导致的间接费用在内的社会视角。从 73406 名患者中，5440 名患者（7.4% [95% CI 7.2%；7.6%]）报告至少出现过一次不良反应，1422 名患者（1.9% [1.8%；2.0%]）需要治疗。随后报告的治疗方法包括自我治疗（1.2% [1.09%；1.25%]）、药物治疗和/或医生治疗（0.6% [0.57%；0.68%]），或住院治疗（0.03% [0.02%；0.04%]）。与未出现不良反应的患者相比，报告需治疗的不良反应的患者费用更高（3 个月时为 1265 欧元 [1179 欧元；1351 欧元]，12 个月时为 3534 欧元 [3256 欧元；3812 欧元]）。这种差异是由看医生的费用和更高的间接费用造成的（3 个月时差异为 125 欧元 [38 欧元；211 欧元]，p=0.005，12 个月时差异为 285 欧元 [4 欧元；566 欧元]，p=0.047）。针灸引起的不良反应在约 7%的患者中发生，主要由他们自行治疗。当这些不良反应需要由医疗专业人员治疗时，就会产生额外的费用。
