School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK.
BMC Fam Pract. 2011 Jun 13;12:49. doi: 10.1186/1471-2296-12-49.
Spinal manipulation and acupuncture can be helpful in reducing the symptoms of musculoskeletal (MSK) pain. Both approaches are currently recommended by NICE as treatment options for patients with persistent low back pain. However, there has been no previous evaluation of a GP service using them together for MSK pain. The purpose of this study was to evaluate acceptability and outcomes for an osteopathy and acupuncture service (delivered by complementary therapy practitioners) for patients with MSK problems provided within a General Practice.
Patients were asked to complete a questionnaire before and after their course of treatment. Outcome measures included the Bournemouth Questionnaire (measuring MSK problems), EuroQoL-5D (measuring quality of life), medication use, physical activity and general well-being. Non-parametric tests were used to compare pre- and post- treatment variables. Qualitative data, regarding participants' views on the service, were collected from patients via a service survey and healthcare professionals via interviews. Qualitative data were analysed using thematic analysis.
123 adults with MSK problems were referred into the service (79 female and 44 male, mean age 49 years). Complete patient questionnaire data sets (pre- and post- treatment) were available for 102 participants; 91 completed a service survey. All healthcare professionals involved in the service participated in interviews including all seven GPs and the administration manager at the practice, as well as the three acupuncture/osteopathy practitioners. Patient outcomes: comparisons between pre and post-treatment revealed a statistically significant improvement in MSK pain (p < 0.0001) and quality of life (p < 0.0001), and a statistically significant reduction in medication use (p < 0.0001). Qualitative analysis found that patients reported improvements in their MSK pain, mobility, other physical health conditions, well-being and self-management of their MSK problem.Acceptability of the service: overall patients and healthcare professionals were satisfied with the service and its provision within the Practice. Patients reported wanting increased appointment availability and flexibility, and more sessions. Complementary therapy practitioners reported finding the high number of referrals of chronic patients challenging, and wanting increased communication with GPs.
Provision of acupuncture and osteopathy for MSK pain is achievable in General Practice. A GP surgery can quickly adapt to incorporate complementary therapy provided key principles are followed.
脊柱推拿和针灸在减轻肌肉骨骼（MSK）疼痛症状方面可能有所帮助。NICE 目前推荐这两种方法作为持续性腰痛患者的治疗选择。然而，以前没有评估过将这两种方法结合起来用于 MSK 疼痛的全科医生服务。本研究的目的是评估在普通诊所提供的针对 MSK 问题的整骨和针灸服务（由补充治疗从业者提供）的可接受性和结果。
患者在治疗前后被要求完成一份问卷。结果测量包括 Bournemouth 问卷（测量 MSK 问题）、EuroQoL-5D（测量生活质量）、药物使用、身体活动和整体健康状况。使用非参数检验比较治疗前后的变量。通过患者服务调查和医疗保健专业人员访谈收集有关参与者对服务看法的定性数据。使用主题分析对定性数据进行分析。
123 名 MSK 问题成年人被转介到该服务中（79 名女性和 44 名男性，平均年龄 49 岁）。102 名参与者提供了完整的患者问卷数据集（治疗前后）；91 名完成了服务调查。所有参与该服务的医疗保健专业人员都参与了访谈，包括所有 7 名全科医生和该实践的管理人员，以及 3 名针灸/整骨从业者。患者结果：治疗前后的比较显示，MSK 疼痛（p < 0.0001）和生活质量（p < 0.0001）有统计学意义的改善，药物使用（p < 0.0001）有统计学意义的减少。定性分析发现，患者报告称他们的 MSK 疼痛、活动能力、其他身体健康状况、幸福感和对 MSK 问题的自我管理都有所改善。服务的可接受性：总体而言，患者和医疗保健专业人员对服务及其在实践中的提供感到满意。患者报告希望增加预约的可用性和灵活性，并增加更多的疗程。补充治疗从业者报告说，他们发现慢性患者的大量转介具有挑战性，并希望增加与全科医生的沟通。
在普通诊所提供针对 MSK 疼痛的针灸和整骨治疗是可行的。如果遵循关键原则，全科医生手术可以快速适应并纳入补充治疗。
