title: Outcomes of acupuncture for chronic pain in urban primary care.
abstract: OBJECTIVE
  The purpose of this study was to describe outcomes of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, testing acupuncture as an adjunct to usual treatment for chronic pain in urban health centers.
  
  
  METHODS
  We conducted a quasi-experimental trial. Primary care patients (>21 years old) with chronic pain caused by osteoarthritis or neck or back pain at 4 hospital-owned safety net health centers in the Bronx, New York, received weekly acupuncture treatments provided by supervised acupuncture students for up to 14 weeks. Pain and functional status were assessed during a 6-week run-in period before acupuncture, during treatment, and after treatment.
  
  
  RESULTS
  Of 495 referred patients, 226 (47%) initiated acupuncture. Back pain was the most common referring diagnosis (59.5%) followed by osteoarthritis (16.3%). Patients were older (mean age, 54.3 years), mostly insured by Medicaid (60.4%), often receiving disability (38.3%), and often in poor or fair overall health (46.7%). They had high baseline levels of pain (mean severity per the Brief Pain Inventory, 6.8; mean days with pain, 12.3 of 14). The mean number of treatments was 9.7 (standard deviation, 7.3). Pain severity improved from baseline (6.8 vs. 5.6 at 12 weeks and 5.5 at 24 weeks), as did physical well-being (31.8 vs. 35.7 at 12 weeks and 35.3 at 24 weeks). Using hierarchical linear modeling methods, reduction in pain severity between baseline and the treatment phase was significant (P < .001). Improvements in physical well-being were significant at 12 and 24 weeks after baseline (P < .001).
  
  
  CONCLUSIONS
  Referred primary care patients experienced high levels of pain and pain-related disability. Weekly acupuncture was associated with short-term improvements in pain and quality of life.
authors.affiliation: the Department of Family and Social Medicine, lbert Einstein College of Medicine, Bronx, NY; the Department of Integrative Medicine, Beth Israel Medical Center, New York, NY; the Swedish Institute, New York, NY; and the Pacific College of Oriental Medicine, New York, NY.
authors.forename: M Diane
authors.initials: MD
authors.lastname: McKee
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kligler
authors.forename: Jason
authors.initials: J
authors.lastname: Fletcher
authors.forename: Francesca
authors.initials: F
authors.lastname: Biryukov
authors.forename: William
authors.initials: W
authors.lastname: Casalaina
authors.forename: Belinda
authors.initials: B
authors.lastname: Anderson
authors.forename: Arthur
authors.initials: A
authors.lastname: Blank
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D059350:Chronic Pain / Q000534:rehabilitation*; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D019037:Urban Health Services; D014505:Urban Population
keywords: Acupuncture; Chronic Pain; Complementary Medicine; Underserved Populations