Acupuncture in patients with dysmenorrhea

a randomized study on clinical effectiveness and cost-effectiveness in usual care

Witt, Claudia M. MD, MBA
Reinhold, Thomas MSc
Brinkhaus, Benno MD
Roll, Stephanie MSc
Jena, Susanne MSc
Willich, Stefan N. MD, MPH, MBA

Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.

Reprints: Dr Claudia M. Witt, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, 10098 Berlin, Germany. [email protected]

This study was funded by health insurance companies, including the Techniker Krankenkasse (TK), Betriebskrankenkasse (BKK) Aktiv, Bosch BKK, DaimlerChrysler BKK, Bertelsmann BKK, BKK BMW, Siemens-Betriebskrankenkasse (SBK), BKK Deutsche Bank, BKK Hoechst, HypoVereinsbank BKK, Ford BKK, Betriebskrankenkasse der Allianz Gesellschaften, Vereins- und Westbank BKK, Handelskrankenkasse (HKK), and Innungskrankenkasse (IKK) Hamburg.

Received March 28, 2007; revised May 4, 2007; accepted July 24, 2007.

American Journal of Obstetrics and Gynecology 198(2):p 166e1-166e8, February 2008.

OBJECTIVE

To investigate the clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhea.

STUDY DESIGN

In a randomized controlled trial plus non-randomized cohort, patients with dysmenorrhea were randomized to acupuncture (15 sessions over three months) or to a control group (no acupuncture). Patients who declined randomization received acupuncture treatment. All subjects were allowed to receive usual medical care.

RESULTS

Of 649 women (mean age 36.1 ± 7.1 years), 201 were randomized. After three months, the average pain intensity (NRS 0–10) was lower in the acupuncture compared to the control group: 3.1 (95% CI 2.7; 3.6) vs. 5.4 (4.9; 5.9), difference −2.3 (−2.9; −1.6); P<.001. The acupuncture group had better quality of life and higher costs. (overall ICER €3,011 per QALY).

CONCLUSION

Additional acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost-effective within usual thresholds.