Zhen Zheng1, Stephen Gibson2, Robert D Helme3, Yanyi Wang1, David Shao-Chen Lu1, Carolyn Arnold4,5, Malcolm Hogg6, Andrew A Somogyi7, Cliff Da Costa8, Charlie Chang Li Xue1. 1. School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. 2. National Ageing Research Institute, Parkville, Victoria, Australia. 3. Department of Medicine. 4. Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia. 5. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. 6. Pain Services, Royal Melbourne Hospital, Parkville, Victoria, Australia. 7. Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia. 8. School of Science, RMIT University, Bundoora, Victoria, Australia.
Abstract
OBJECTIVES: To evaluate the efficacy and safety of electroacupuncture in reducing opioid consumption in patients with chronic musculoskeletal pain. DESIGN: A randomized, participant-assessor-blinded, three-arm trial. SETTING:Participants from three pain clinics and from the public. SUBJECTS:One hundred and eight adults with chronic pain who were taking opioids. METHODS: All participants received pain and medication management education. Participants were randomly allocated to electroacupuncture (N = 48), sham electroacupuncture (N = 29), or education alone (N = 31) to receive relevant treatment for 12 weeks. The last group received electroacupuncture during the three-month follow-up. Analysis of covariance and paired t tested were used. RESULTS: Opioid dosage, that is, the primary outcome measure, was reduced by 20.5% (P < 0.05) and 13.7% (P < 0.01) in the two acupuncture groups and by 4.5% in the education group at the end of the treatment phase, but without any group difference. Intensity of pain of all three groups did not change over time. No group differences were found in dosage of nonopioid analgesics, pain intensity, function, and opioid-related adverse events. During follow-up, the education group had a 47% reduction of opioids after a course of electroacupuncture. Adverse events to electroacupuncture were minor. CONCLUSION: It is safe to reduce opioid medication use in patients with chronic pain. Due to the small sample size, we could not confirm if electroacupuncture offers extra benefit in addition to education. This nondrug therapy could be a promising adjunct to facilitate opioid tapering in patients who are willing to reduce opioids.
RCT Entities:
OBJECTIVES: To evaluate the efficacy and safety of electroacupuncture in reducing opioid consumption in patients with chronic musculoskeletal pain. DESIGN: A randomized, participant-assessor-blinded, three-arm trial. SETTING:Participants from three pain clinics and from the public. SUBJECTS: One hundred and eight adults with chronic pain who were taking opioids. METHODS: All participants received pain and medication management education. Participants were randomly allocated to electroacupuncture (N = 48), sham electroacupuncture (N = 29), or education alone (N = 31) to receive relevant treatment for 12 weeks. The last group received electroacupuncture during the three-month follow-up. Analysis of covariance and paired t tested were used. RESULTS: Opioid dosage, that is, the primary outcome measure, was reduced by 20.5% (P < 0.05) and 13.7% (P < 0.01) in the two acupuncture groups and by 4.5% in the education group at the end of the treatment phase, but without any group difference. Intensity of pain of all three groups did not change over time. No group differences were found in dosage of nonopioid analgesics, pain intensity, function, and opioid-related adverse events. During follow-up, the education group had a 47% reduction of opioids after a course of electroacupuncture. Adverse events to electroacupuncture were minor. CONCLUSION: It is safe to reduce opioid medication use in patients with chronic pain. Due to the small sample size, we could not confirm if electroacupuncture offers extra benefit in addition to education. This nondrug therapy could be a promising adjunct to facilitate opioid tapering in patients who are willing to reduce opioids.
Authors: Abhimanyu Sud; Michelle L A Nelson; Darren K Cheng; Alana Armas; Kirk Foat; Michelle Greiver; Fardous Hosseiny; Joel Katz; Rahim Moineddin; Benoit H Mulsant; Ronnie I Newman; Leon Rivlin; Akshya Vasudev; Ross Upshur Journal: Trials Date: 2020-04-07 Impact factor: 2.279