Thursday, April 18, 2024
4/18/2024
Project Summary: The purpose of this project is to determine the effectiveness of acupuncture in the Emergency Department (ED) for improving outcomes in patients with acute musculoskeletal pain. The overall goals are to reduce pain, disability, and opioid use by expanding acupuncture as a non-opioid, non-pharmacologic treatment option for patients during their time of most severe pain. Population to be served: The primary population for this project will be adult ED patients (18 years or older) with acute musculoskeletal pain (4-5% of all ED visits) seen at Duke University Hospital, a tertiary care center in central North Carolina with a large catchment area from across the state. All adult ED patients will be potentially eligible. Potential subjects will be identified by screening for adults with chief complaints of acute musculoskeletal neck, back or extremity pain, including pain caused by injuries, motor vehicle crashes, falls or non-traumatic conditions. Recruitment will not be restricted based on gender, upper age limit, race/ethnicity or socioeconomic status. The Duke ED sees approximately 50% women, 40% African Americans, and 40% Caucasian patients. Among these patients, 22% receive Medicaid, 26% receive Medicare, and 16% are uninsured. Project Intervention: Acupuncture is increasingly recognized as an effective treatment for pain in the clinic setting, but it has yet to be established as a first-line treatment in the ED. Therefore, we will conduct a pragmatic randomized controlled trial to determine the effectiveness of acupuncture for reducing pain and opioid use in ED patients with acute musculoskeletal pain. The first acupuncture session will be delivered in the ED, with twice a week follow-up acupuncture sessions for up to one month or until pain resolution. Follow-up sessions will be provided through a group-based after-hours acupuncture clinic to improve access and affordability. Both the acupuncture and control groups will also receive usual care for musculoskeletal pain, such as pain medications, at the discretion of the ED provider. Project Goals: The goal of this project is to determine the efficacy of acupuncture plus usual care for reducing pain, disability and opioid use both acutely (while in the ED 1 hour after treatment), and longer term (4 weeks after combined ED and outpatient acupuncture treatments) compared to usual care alone. This study aims to enroll 200 patients per year for 2.5 years for a total of 500 patients, with 2/3 of patients randomized to receive acupuncture and 1/3 of patients randomized to the control arm. By establishing the necessary evidence-base, this study will facilitate the future implementation and dissemination of acupuncture as a viable treatment option for acute pain reduction in the ED.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
