BACKGROUND: Medically unexplained physical symptoms (MUPS) are common and difficult to treat. AIM: To investigate the effectiveness of adding five-element acupuncture to usual care in 'frequent attenders' with MUPS. DESIGN AND SETTING: Randomised controlled trial in four London general practices. METHOD: Participants were 80 adults with MUPS, consulting GPs >= 8 times/year. The intervention was individualised five-element acupuncture, >= 12 sessions, immediately (acupuncture group) and after 26 weeks (control group). The primary outcome was 26-week Measure Yourself Medical Outcome Profile (MYMOP); secondary outcomes were wellbeing (W-BQ12), EQ-5D, and GP consultation rate. Intention-to-treat analysis was used, adjusting for baseline outcomes. RESULTS: Participants (80% female, mean age 50 years, mixed ethnicity) had high health-resource use. Problems were 59% musculoskeletal; 65% > 1 year duration. The 26-week questionnaire response rate was 89%. Compared to baseline, the mean 26-week MYMOP improved by 1.0 (95% confidence interval (CI) 0.4 to 1.5) in the acupuncture group and 0.6 (95% CI 0.3 to 0.9) in the control group (adjusted mean difference: acupuncture versus control -0.6, 95% CI -1.1 to 0, p = 0.05). Other between-group adjusted mean differences were: W-BQ12 4.4 (95% CI 1.6 to 7.2, p = 0.002); EQ-5D index 0.03 (95% CI -0.11 to 0.16, p = 0.70); consultation rate ratio 0.90 (95% CI 0.70 to 1.15, p = 0.4); and number of medications 0.56 (95% CI 0.47 to 1.6, p = 0.28). All differences favoured the acupuncture group. Imputation for missing values reduced the MYMOP adjusted mean difference to -0.4 (95% CI -0.9 to 0.1, p = 0.12). Improvements in MYMOP and W-BQ12 were maintained at 52 weeks. CONCLUSION: The addition of 12 sessions of five-element acupuncture to usual care resulted in improved health status and wellbeing that was sustained for 12 months.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• PDF locator
• publisher