The effectiveness of a case management model in improving treatment access, retention, and outcomes was examined within a cohort of 360 intravenous drug users (IDUs) pursuing substance-abuse treatment through a central intake facility. IDUs were randomly assigned either to the case management group or to the comparison group. In the case managed condition, IDUs received assistance from their case manager in identifying and accessing needed services, including substance abuse treatment. In the comparison condition, IDUs received limited referral information for substance abuse treatment. Clients in the case managed group accessed substance abuse treatment in significantly greater numbers and more rapidly than clients in the comparison group. Case-managed clients also remained in substance abuse treatment nearly twice as long as did comparison group clients. Finally, case-managed clients showed better treatment outcomes including reduced alcohol and drug use.
Introduction
The incidence of vulvodynia in American women has been reported to be between 8.3% and 16%. However, there is no consistently effective standardized treatment for vulvodynia.
Aim
To determine the feasibility and potential effects of using a standardized acupuncture protocol for the treatment of women with vulvodynia.
Main Outcome Measures
The primary outcome was vulvar pain, and sexual function was the secondary outcome. Pain was assessed by the Short-Form McGill Pain Questionnaire, and function was measured by the Female Sexual Function Index (FSFI).
Methods
Thirty-six women with vulvodynia met inclusion criteria. The women were randomly assigned either to the acupuncture group or to the wait-list control group. The 18 subjects assigned to the acupuncture group received acupuncture two times per week for 5 weeks for a total of 10 sessions.
Results
Reports of vulvar pain and dyspareunia were significantly reduced, whereas changes in the aggregate FSFI scores suggest significant improvement in sexual functioning in those receiving acupuncture vs. those who did not. Acupuncture did not significantly increase sexual desire, sexual arousal, lubrication, ability to orgasm or sexual satisfaction in women with vulvodynia.
Conclusion
This was the first randomized controlled pilot study to examine the use of acupuncture for the treatment of vulvodynia. The acupuncture protocol was feasible and in this small sample appeared to reduce vulvar pain and dyspareunia with an increase in overall sexual function for women with vulvodynia. This study should be replicated in a larger double-blinded randomized controlled trial.
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