Acupuncture of benefit to those with unexplained symptoms

Attending frequently with medically unexplained symptoms is distressing for both patient and doctor and effective treatment or management options are limited: one in five patients have symptoms that remain unexplained by conventional medicine. Studies have shown that the cost to the NHS of managing the treatment of a patient with medically unexplained symptoms can be twice that of a patient with a diagnosis.

A research team from the Institute of Health Services Research, Peninsula Medical School, University of Exeter, has carried out a randomised control trial and a linked interview study regarding 80 such patients from GP practices across London, to investigate their experiences of having five-element acupuncture added to their usual care. This is the first trial of traditional acupuncture for people with unexplained symptoms.

The results of the research are published in the British Journal of General Practice. They reveal that acupuncture had a significant and sustained benefit for these patients and consequently acupuncture could be safely added to the therapies used by practitioners when treating frequently attending patients with medically unexplained symptoms.

The patient group was made up of 80 adults, 80 per cent female with an average age of 50 years and from a variety of ethnic backgrounds who had consulted their GP at least eight times in the past year. Nearly 60 per cent reported musculoskeletal health problems, of which almost two-thirds had been present for a year.

In the three months before taking part in the study, the 80 patients had accounted for the following NHS experiences: 21 patient in-days; 106 outpatient clinic visits; 52 hospital clinic visits (for treatments such as physiotherapy, chiropody and counselling); 44 hospital visits for investigations (including 10 magnetic resonance imaging – MRI – scans); and 75 visits to non-NHS practitioners such as opticians, dentists and complementary therapists.

The patients were randomly divided into an acupuncture group and a control group. Eight acupuncturists administered individual five-element acupuncture to the acupuncture group immediately, up to 12 sessions over 26 weeks. The same numbers of treatments were made available to the control group after 26 weeks.

At 26 weeks the patients were asked to complete a number of questionnaires including the individualised health status questionnaire "Measure Yourself Medical Outcome Profile."

The acupuncture group registered a significantly improved overall score when compared with the control group. They also recorded improved wellbeing but did not show any change in GP and other clinical visits and the number of medications they were taking. Between 26 and 52 weeks the acupuncture group maintained their improvement and the control group, now receiving their acupuncture treatments, showed a 'catch up' improvement.

The associated qualitative study, which focused on the patients' experiences, supported the quantitative work.