Acupuncture for chronic pain in adults with sickle cell disease: a mixed-methods pilot study

Abstract

Objective: Chronic pain is a common symptom experienced among patients with sickle cell disease (SCD). Our aims were to assess the feasibility and acceptability of performing acupuncture for the treatment of chronic pain in adults with SCD. Methods: This was a single-arm, prospective pilot study of six adults with SCD. Participants reported ⩾ 3 months of chronic pain and were > 18 years of age. Per protocol, acupuncture was to be administered twice per week for 5 weeks, for 30 min per session. All treatments were performed in the acupuncture treatment laboratory at the University of Illinois Chicago College of Nursing. Pain intensity, pain interference, and other symptoms were measured at baseline and after the intervention. Participants completed a semi-structured interview and a protocol acceptability questionnaire after the acupuncture intervention. Results: Six participants (mean age 52.5 years, six Black) were enrolled. Although the study was suspended due to COVID-19 and not all participants completed the 10-session protocol, completion rates were high with no missed appointments. One participant did not complete the study due to hospitalization unrelated to acupuncture. No adverse events were reported. At completion of the intervention at 4–5 weeks post-baseline, all participants had reduced pain intensity and pain interference. The mean acceptability score on the protocol acceptability questionnaire was 82%. Conclusion: It was feasible and acceptable to implement acupuncture in adults with SCD. This study can be used to guide a larger randomized controlled trial to evaluate the effect of acupuncture on reducing chronic pain in adults with SCD. Trial registration number: NCT04156399 (ClinicalTrials.gov)

Hybrid effectiveness-implementation trial of guided relaxation and acupuncture for chronic sickle cell disease pain (GRACE): A protocol

“…All participants will be scheduled to complete assessments at 4 time points: baseline (at study enrollment), week 6 (midpoint), week 12 (intervention end), and week 24 (follow-up). The rationale for the 6-week assessment time point is based on our clinical knowledge and our pilot studies [ 15 , 39 ], which have shown positive effects of CIH therapies after 5 weeks of intervention.…”

“…Since many people with SCD try 2 or more therapies, there is a need to rigorously test the effects of adding a subsequent therapy when the first does not produce the desired outcomes within a given time period. The Hybrid Effectiveness-implementation Trial of Guided Relaxation and Acupuncture for Chronic Sickle Cell Disease Pain (GRACE) is assessing the outcomes of sequencing 2 evidence-based CIH therapies [ 15 , 16 ], acupuncture and guided relaxation, among SCD patients with chronic pain who are being treated in real-world health care systems.…”

“…These meta-analyses of acupuncture have established the effectiveness of acupuncture for treating chronic pain conditions other than SCD, and suggest that it may also be effective for the treatment of adults with SCD and chronic pain. There are also promising small studies of acupuncture for the treatment of SCD pain [ 15 , 21 , 22 ].…”

Understanding the Autonomic Nervous System: A How-To Guide for Designing Engaging Pathophysiology and Pharmacology Courses for Nursing Students

“…Students shared information about many additional clinically relevant topics during our course discussions, such as circadian rhythm and sleep disorders (e.g., shift-work sleep disorder, narcolepsy, and sleep apnea) and the efects of hypnotic and stimulant drugs. We also provided exposure to relevant faculty research activities; for example, one faculty member (JMS) is a nurse scientist and a licensed acupuncturist, and her team's research illustrated how acupuncture can be used to manage pain and cardiovascular disorders, according to its efects on the ANS [10][11][12]. Other faculty members with active research programs incorporated examples from their relevant work about neuroscience (MWC and AMF; [13,14]), stroke (SRM; [15]), diabetes (CF and LQ; [16]), and the microbiome (MBL; [17]).…”

Avanços no uso clínico da acupuntura e possibilidades para o campo da enfermagem e da saúde: uma revisão integrativa

“…Atualmente os opioides são uma forma comum de controle da dor na doença falciforme, mas que está associada a múltiplos efeitos colaterais e dependência, o que inspira novas formas de analgesia nesses pacientes. Nesse sentido, em estudo piloto recente, a realização de acupuntura por 5 semanas se mostrou viável e aceitável para tratamento da dor crônica em adultos com doença falciforme, mas que é preciso um estudo controlado randomizado maior para avaliar os efeitos da acupuntura (Li et al, 2021).…”