Kim Song-Yi, Lee Hyejung, Lee Hyangsook, Park Ji-Yeun, Park Sang Kyun, Park Hi-Joon
Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
Department of Meridian and Acupoint, College of Korean Medicine, Sang Ji University, Wonju, Republic of Korea.
Acupunct Med. 2015 Apr;33(2):148-53. doi: 10.1136/acupmed-2014-010641. Epub 2014 Dec 23.
To investigate the consequences and costs of acupuncture in general medical practice for patients with chronic low back pain (CLBP) in Korea.
A multicentre observational study was performed. Outpatients with CLBP who received at least one acupuncture session in a Korean Medicine clinic during the study period were included and followed up for 3 months. All patients received regular acupuncture treatments in accordance with the doctors' discretion. The consequences in terms of effects included condition-specific outcomes and preference-based outcome. For cost analysis, the cumulative resource use for direct medical costs at each research clinic during the study period and direct patient data using the self-reported healthcare utilisation questionnaires were used.
A total of 157 patients were eligible to participate and 105 were finally included. Significant improvements in condition-specific and preference-based measures were observed after acupuncture treatment. An average of approximately $146 (£93) per patient was reported for direct medical costs in each clinic for 1 month and $231 (£148) for 3 months. Other medical expenses related to CLBP were reduced during this period.
The use of acupuncture to manage CLBP in general clinical practice in Korea inexpensively improved pain, functional disability and quality of life. The study results are meaningful and consistent with the results of previous trials performed in other European countries but the power of the study is not strong, having major design weaknesses. A large-scale cohort or registry based on practice may be helpful to strengthen the evidence of the cost-effectiveness of acupuncture.
调查韩国普通医疗实践中针灸治疗慢性下腰痛(CLBP)患者的疗效及成本。
开展一项多中心观察性研究。纳入研究期间在韩国传统医学诊所接受至少一次针灸治疗的CLBP门诊患者,并随访3个月。所有患者均根据医生的判断接受常规针灸治疗。疗效方面的结果包括特定病情结局和基于偏好的结局。成本分析使用研究期间各研究诊所直接医疗成本的累积资源使用情况以及通过自我报告的医疗保健利用问卷收集的直接患者数据。
共有157名患者符合参与条件,最终纳入105名。针灸治疗后,特定病情和基于偏好的指标均有显著改善。各诊所报告每名患者每月直接医疗成本平均约为146美元(93英镑),3个月为231美元(148英镑)。在此期间,与CLBP相关的其他医疗费用有所减少。
在韩国普通临床实践中,使用针灸治疗CLBP可廉价地改善疼痛、功能障碍和生活质量。研究结果具有意义,且与之前在其他欧洲国家进行的试验结果一致,但该研究的效力不强,存在重大设计缺陷。基于实践的大规模队列研究或注册研究可能有助于加强针灸成本效益的证据。