Adverse events following acupuncture: A prospective survey of 13,884 consultations in a university out-patient acupuncture training clinic in Brazil

Silva, João Bosco Guerreiro da; Saidah, Rassen; Megid, Cecília Baccili Cury; Ramos, Neil Alvimar

doi:10.1016/j.eujim.2013.12.022

Cited by 5 publications

(12 citation statements)

References 28 publications

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“…33 41 46 49 Three nationwide surveys from the UK (described in four articles), 38–40 48 one in-house surveillance report from Japan, 51 and one summary of AE assessments nested within three Chinese RCTs 52 included 2000–6000 patients receiving over 30 000 treatments, respectively. In three surveys, two from South Korea, 44 45 one from Japan, 35 and one from Brazil, 32 around 1000–2000 patients were included and treated in up to 14 000 acupuncture sessions. One nationwide survey conducted in Sweden assessed the AE risk based on data from over 9000 acupuncture sessions.…”

Section: Resultsmentioning

confidence: 99%

“… 34–36 43 50 In two trials, AEs were documented by an independent assessor. 42 47 In eight of the 22 included articles, AEs were reported irrespective of their relationship to acupuncture, 31 33 34 37 40 48 51 52 while descriptions of AE assessments in 14 articles suggest that only AEs related to the acupuncture treatment were documented, 31 32 35 36 38 39 41–44 46 47 49 50 and one article did not provide information about the AE definition. 45 Further discrepancies were found in definitions of certain reactions as therapeutically intended.…”

Section: Resultsmentioning

confidence: 99%

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Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies

et al. 2021

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ObjectiveOverview on risks of acupuncture-related adverse events (AEs).DesignSystematic review and meta-analyses of prospective studies.Data sourcesPubMed, Scopus and Embase from inception date to 15 September 2019.Eligibility criteria for selecting studiesProspective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German.Data extraction and synthesisTwo independent researchers selected articles, extracted the data and assessed study quality. Overall risks and risks for different AE categories were obtained from random effects meta-analyses.Main outcomesOverall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments.ResultsA total of 7679 publications were identified. Twenty-two articles reporting on 21 studies were included. Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was substantial (I2 >80%). On average, 9.4 AEs occurred in 100 treatments. Half of the AEs were bleeding, pain or flare at the needle site that are argued to represent intended acupuncture reaction. AE definitions and assessments varied largely.ConclusionAcupuncture can be considered among the safer treatments in medicine. SAEs are rare, and the most common minor AEs are very mild. AEs requiring medical management are uncommon but necessitate medical competence to assure patient safety. Clinical and methodological heterogeneity call for standardised AE assessments tools, clear criteria for differentiating acupuncture-related AEs from therapeutically desired reactions, and identification of patient-related risk factors for AEs.PROSPERO registration numberCRD42020151930.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies

et al. 2021

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“…[ 22 ] In acupuncture treatment, some patients may have mild bleeding and ecchymosis. [ 23 , 24 ] Moxibustion treatment may result in erythema, mild burns, and allergic reaction in some patients. [ 24 , 25 ] However, there are no expected severe adverse events, which are defined as death, life-threatening adverse experiences, hospitalization or prolongation of existing hospitalization, persistent or significant disability/incapacity, or the potential for a congenital anomaly/birth defect resulting from pregnancy.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness, safety, and economic evaluation of Korean medicine for unexplained infertile women

Kim

2017

Medicine

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Infertility is a condition in which a woman has not been pregnant despite having had normal intercourse for 1 year. The number of unexplained infertile females is increasing because of late marriage customs, as well as environmental and lifestyle habits. In Korea, infertile females have been treated with Korean medicine (KM). However, these effects have not been objectively confirmed through clinical trials. Therefore, this study was conducted to demonstrate the effectiveness of herbal medicine treatment in infertile patients and to demonstrate the economic feasibility through economical evaluation with assisted reproductive technology.This study is designed as a multicenter, single-arm clinical trial. All participants included will be from 3 Korean Medicine hospitals in Korea and will voluntarily sign an informed consent agreement. All recruited patients will conduct related surveys and tests, and be provided with treatment according to their menstrual cycle. Patients will take herbal medicines for 4 menstruation cycles and receive acupuncture and moxibustion treatment at 3 times (menstrual cycle day 3, 8, 14) during 4 menstruation cycles. They will also undergo an approximately 4 menstrual cycle treatment period, and 3 menstrual cycle observation period. If pregnant during the study, participants will take the herbal medicine for implantation for about 15 days. In this study, the primary outcome will be the clinical pregnancy rate, whereas the secondary outcome will include the implantation rate, ongoing pregnancy rate, and live birth rate.Ultimately, this study will provide clinical data regarding the effectiveness and safety of KM treatment for females with unexplained infertility and important evidence for establishing standard KM treatments for unexplained infertility. Moreover, we will identify the most cost-effective way to treat unexplained infertility.

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“…The study concluded that the rate of minor adverse events per appointment was 7.97%; hematomas and bleeding were the most common events, accounting for 50% of the total, followed by pain at the site of needling and itching. 31 Another study, like that of Rio Preto, concluded that event rates were generally classified as minimal. 31,32…”

Section: Discussionmentioning

confidence: 99%

“…31 Another study, like that of Rio Preto, concluded that event rates were generally classified as minimal. 31,32…”

Section: Discussionmentioning

confidence: 99%

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

et al. 2020

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Background: An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. Objective: To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. Method: A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. Results: Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. Conclusion: Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.

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Adverse events following acupuncture: A prospective survey of 13,884 consultations in a university out-patient acupuncture training clinic in Brazil

Cited by 5 publications

References 28 publications

Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies

Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies

The effectiveness, safety, and economic evaluation of Korean medicine for unexplained infertile women

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

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