title: The ADDOPT study (Acupuncture to Decrease Disparities in Outcomes of Pain Treatment): feasibility of offering acupuncture in the community health center setting.
abstract: OBJECTIVE
  This article describes the feasibility and acceptability of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, which incorporates acupuncture as an adjunct to usual treatment for chronic pain in urban health centers.
  
  
  METHODS
  The study assessed feasibility (ability to carry out in real-world practice; adequacy of resources; acceptability to patients, acupuncturists, and primary care clinicians).
  
  
  METHODS
  Four (4) community health centers in the Bronx, NY, participating in the New York City Research and Improvement Networking Group (NYC RING), a practice-based research network dedicated to decreasing health disparities through primary care research and quality improvement in the urban safety net setting, were involved.
  
  
  METHODS
  The subjects comprised participants receiving care for chronic pain due to osteoarthritis, or neck or back pain at four Bronx health centers serving low-income families.
  
  
  METHODS
  The intervention involved up to 14 weekly acupuncture treatments.
  
  
  METHODS
  Pain and functional status are assessed during a 6-week run-in period before, during, and postacupuncture treatment using the Brief Pain Inventory and the 12-Item Short Form Health Survey. This article reports on baseline status, referral and recruitment, engagement with treatment, and delivery of the intervention across sites.
  
  
  RESULTS
  Of 400 patients referred, 185 have initiated treatment. The majority of attending physicians have referred, most commonly for back pain (n=103; 60.6%). Participants' average age is 53.9 (standard deviation [SD] 14.1); 54.1% are Hispanic; and 57.6% are on Medicaid. Half (48%) report "poor" or "fair" overall health. Patients report an average disability score of 74 (SD 27.0) and baseline pain severity on the Brief Pain Inventory of 6 (SD 1.9). Patients have completed a mean of 8.0 (SD 4.7) treatments; 72.4% complete >5 sessions.
  
  
  CONCLUSIONS
  Clinicians in this urban setting have incorporated acupuncture into chronic pain management. Despite disability and lack of familiarity, patients initiate acupuncture and show high levels of engagement with treatment.
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: M Diane
authors.initials: MD
authors.lastname: McKee
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kligler
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
authors.forename: Jason
authors.initials: J
authors.lastname: Fletcher
authors.forename: Anne
authors.initials: A
authors.lastname: Jeffres
authors.forename: William
authors.initials: W
authors.lastname: Casalaina
authors.forename: Francesca
authors.initials: F
authors.lastname: Biryukov
mesh_terms: D000203:Activities of Daily Living; D015670:Acupuncture Therapy; D000328:Adult; D000367:Age Factors; D001416:Back Pain / Q000628:therapy*; D059350:Chronic Pain / Q000628:therapy*; D003153:Community Health Services; D005006:Ethnicity; D006304:Health Status; D006801:Humans; D008484:Medicaid; D019547:Neck Pain / Q000628:therapy*; D009519:New York City; D010003:Osteoarthritis / Q000150:complications; D059408:Pain Management; D010342:Patient Acceptance of Health Care; D011203:Poverty; D012017:Referral and Consultation; D012720:Severity of Illness Index; D014481:United States; D014505:Urban Population