title: Treatment of the adverse effects from acupuncture and their economic impact: a prospective study in 73,406 patients with low back or neck pain.
abstract: 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.
authors.affiliation: Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany. claudia.witt@charite.de
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Witt
authors.forename: Daniel
authors.initials: D
authors.lastname: Pach
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinhold
authors.forename: Katja
authors.initials: K
authors.lastname: Wruck
authors.forename: Benno
authors.initials: B
authors.lastname: Brinkhaus
authors.forename: Sigrid
authors.initials: S
authors.lastname: Mank
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects* / Q000191:economics*; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D017116:Low Back Pain / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000191:economics* / Q000628:therapy; D011446:Prospective Studies