Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form.
BACKGROUND
To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and, based on these results, to develop a new medical consent form for acupuncture.


METHODS
The prospective observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip, low back pain, neck pain or headache, allergic rhinitis, asthma, or dysmenorrhoea. After treatment, all patients documented adverse events associated with acupuncture (defined as adverse effects). Patients who reported a need for treatment due to an adverse effect completed an additional standardised questionnaire on the most important adverse effect. Based on this data and considering ethical and legal aspects a new consent form was developed.


RESULTS
A total of 229,230 patients received on average 10.2 +/- 3.0 acupuncture treatments. Altogether, 19,726 patients (8.6%) reported experiencing at least one adverse effect and 4,963 (2.2%) reported one which required treatment. Common adverse effects were bleedings or haematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and vegetative symptoms (0.7%). Two patients experienced a pneumothorax (one needed hospital treatment, the other observation only). The longest duration of a side effect was 180 days (nerve lesion of the lower limb). The resulting medical consent form consists of five modules: Introduction to acupuncture and moxibustion, Risks of acupuncture treatment, Conditions which can increase the risk, Doctor's statement, and Consent.


CONCLUSIONS
Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent.
Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany. claudia.witt@charite.de
Claudia M
CM
Witt
Daniel
D
Pach
Benno
B
Brinkhaus
Katja
K
Wruck
Brigitte
B
Tag
Sigrid
S
Mank
Stefan N
SN
Willich
D015670:Acupuncture Therapy / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D032962:Consent Forms / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence*; D059348:Peripheral Nerve Injuries; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012449:Safety; D011795:Surveys and Questionnaires; D013557:Switzerland