Pragmatic Research of Acupuncture eXtended to Inpatient Services (PRAXIS)

acupuncture_handEffective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes, patient satisfaction, and overall hospital costs. Common pharmaceutical approaches for pain, though effective, have serious side effects and are not appropriate for all inpatients.

Findings from randomized controlled trials (RCTs) support the efficacy of acupuncture for a range of symptoms relevant to inpatients including postoperative pain, cancer-related pain, chemotherapy-related nausea and vomiting, and withdrawal from narcotic use. The extent to which findings from RCTs translate to real-world implementation of acupuncture in typical hospital settings is unknown, however.

The UCSF Osher Center for Integrative Medicine is implementing a clinical program offering acupuncture services to inpatients at the UCSF Mt. Zion Hospital. The initiation of acupuncture services provides a unique opportunity to rigorously evaluate the effectiveness of acupuncture in an inpatient clinical setting. The broad goal of the PRAXIS (Pragmatic Research of Acupuncture eXtended to Inpatient Services) study is to examine the value of acupuncture added to routine care for hospitalized patients.

Among inpatients at Mt. Zion Hospital, we aim to assess the effectiveness of acupuncture to manage pain and other symptoms, improve patient satisfaction, and estimate associated hospital costs compared with usual care alone. We are conducting a pragmatic randomized controlled trial to collect preliminary data and establish the key design features for a future R01-level grant. During a 2-month pre-randomization phase, we evaluated and adapted study procedures with acupuncturists and Mt. Zion clinicians and pretest measures and data collection. We then implemented a 6-month randomization phase in which inpatients were randomized to one of two groups, usual care or usual care with daily acupuncture services (125 patients per group).

 

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