The Implementation and Effectiveness of Battlefield Auricular Acupuncture for Pain

Taylor, Stephanie L.; Giannitrapani, Karleen F.; Thomas, Eva R; Federman, Daniel G.; Holliday, Jesse; Olson, Juli; Kligler, Benjamin; Zeliadt, Steven B.

doi:10.1093/pm/pnaa474

Cited by 14 publications

(5 citation statements)

References 18 publications

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“…Participants in both acupuncture intervention arms reported high patient satisfaction and minimal side effects, demonstrating broad acceptability across diverse populations. Our findings underscore those from recent work developing community acupuncture clinics for underserved populations reporting high participant interest in and satisfaction with acupuncture treatments, 18,47,55,56 supporting implementation of acupuncture more broadly to a wide range of patients.…”

Section: Discussionsupporting

confidence: 75%

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

Eucker,

Glass,

Knisely

et al. 2023

Preprint

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ImportanceAcute musculoskeletal pain is challenging to treat in the Emergency Department (ED), a novel setting to incorporate nonpharmacologic interventions, such as acupuncture, to reduce chronic pain.ObjectiveDetermine effectiveness of ED acupuncture for treating acute musculoskeletal pain.DesignPragmatic two-stage adaptive randomized clinical trial over one year. Stage 1 identified whether auricular acupuncture (AA) or peripheral acupuncture (PA) was more feasible and efficacious in the ED. Stage 2 assessed effectiveness of selected ED acupuncture intervention(s) on 1-hour pain reduction compared to no acupuncture (NA).SettingAcademic tertiary-care ED.ParticipantsAdults with acute (≤7 days) musculoskeletal pain in neck, back and/or extremities. Of 911 patients screened, 491 met inclusion criteria, 247 enrolled, 11 withdrew, and 236 were randomized (68 NA, 84 AA, 84 PA).InterventionsAA places ear needles based on battlefield acupuncture. PA places needles in head, neck, and extremity sites distal to pain. Acupuncture was delivered by licensed acupuncturists. All three arms received usual care from blinded ED providers.Main OutcomesPrimary outcome: 11-point Numeric pain rating scale at 1-hour. Secondary outcomes: Satisfaction with treatment; ED opioids given.ResultsInterim analysis at end of Stage 1 found both acupuncture styles similarly feasible and efficacious, so Stage 2 continued all three arms with unequal allocation (from 1:1:1 to 1:2:2 NA:AA:PA). All three arms had similar demographics (mean age 46.1 years ±16.5 SD, 56.2% female, and 53.6% Black), ED baseline pain scores (AA 7.0 ± 2.3, PA 7.2 ± 2.3, NA 6.9 ± 2.2) and pre-baseline ED administration of opioid and non-opioid analgesics. Both AA (2.1 ± 2.9) and PA (1.6 ± 2.0) produced significantly greater 1-hour pain reductions than NA (0.4 ± 1.9).Conclusions and RelevanceTwo different styles of ED acupuncture effectively reduce acute musculoskeletal pain better than usual care alone. Acupuncture is feasible, acceptable, and effective for treating pain in historically underserved populations in the emergency department setting.Clinicaltrials.govregistrationEmergency Department Acupuncture for Acute Musculoskeletal Pain Management ID#:NCT04290741; URL:https://clinicaltrials.gov/ct2/show/NCT04290741Key PointsQuestionWhat is the effectiveness of acupuncture for reducing acute musculoskeletal pain in an emergency department (ED) population?FindingsIn this pragmatic randomized clinical trial of 236 adults, ED patients receiving auricular acupuncture had a mean (± SD) pain score reduction of 2.1 ± 2.9 points, those receiving peripheral acupuncture had a reduction of 1.6 ± 2.0 points, while those who did not receive acupuncture had no change in pain (0.4 ± 1.9), which was a significant difference between no acupuncture and both acupuncture groups.MeaningAcupuncture can be added to usual care to effectively improve acute musculoskeletal pain in the ED.

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Section: Discussionsupporting

confidence: 75%

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

Eucker,

Glass,

Knisely

et al. 2023

Preprint

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“…Battlefield Acupuncture is a protocolized acupuncture treatment currently unique to the VA and military healthcare systems and performed by trained professionals for the purpose of relieving acute and/or chronic pain. 23 As noted above, we examined all VA-covered CIH approaches, which are provided in the VA in a variety of ways (e.g., Whole Health programs, stand-alone yoga programs or clinics, meditation embedded in psychological therapy). These also include community-based CIH paid for by the VA (e.g., acupuncture, chiropractic care, and massage therapy).…”

Section: Cih Approachesmentioning

confidence: 99%

We Built it, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

et al. 2022

Self Cite

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Background Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation’s largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently. Objective This paper addressed the questions of how many VA patients might use CIH approaches and chiropractic care if they were available at modest to no fee, and would patients with some health conditions or characteristics be more likely than others to use these therapies. Design Using electronic medical records, we conducted a national, three-year, retrospective analysis of VA patients’ use of eleven VA-covered therapies: chiropractic care, acupuncture, Battlefield Acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/Qigong, and yoga. Participants We created a national cohort of veterans using VA healthcare from October 2016–September 2019. Key Results Veterans’ use of these approaches increased 70% in three years. By 2019, use was 5.7% among all VA patients, but highest among patients with chronic musculoskeletal pain (13.9%), post-traumatic stress disorder (PTSD; 10.6%), depression (10.4%), anxiety (10.2%), or obesity (7.8%). The approach used varied by age and race/ethnicity, with women being uniformly more likely than men to use each approach. Patients having chronic musculoskeletal pain, obesity, anxiety, depression, or PTSD were more likely than others to use each of the approaches. Conclusions Veterans’ use of some approaches rapidly grew recently and was robust, especially among patients most in need. This information might help shape federal/state health policy on the provision of evidence-based CIH approaches and guide other healthcare institutions considering providing them.

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“…There are a handful of studies that look at auricular acupuncture specifically in treating migraine-type symptoms [12] with conflicting results. BFA, as of now, is still poorly studied and requires much more research to further elucidate its mechanism, indications, dosage, and frequency, as well as its use in acute and chronic pain, musculoskeletal and neuropathic pain, and other types of headaches [13]. Furthermore, thus far, it is generally only accessible to the veteran population through veterans' health centers and most studies have relied on data extrapolated from this group.…”

Section: Discussionmentioning

confidence: 99%

Battlefield Acupuncture for the Treatment of Chronic Migraines

Uddin,

Levine

2024

Cureus

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A 70-year-old man presented with worsening migraines and was referred to a neurologist by their primary care doctor for further workup. Imaging and lab work were benign. The patient then underwent several trials of various first and second-line medications and anti-migraine devices to no avail. It was not until one session of battlefield acupuncture, where five needles were placed in the patient's ear for a few days, that the patient had a resolution of his symptoms.

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The Implementation and Effectiveness of Battlefield Auricular Acupuncture for Pain

Cited by 14 publications

References 18 publications

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

We Built it, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

Battlefield Acupuncture for the Treatment of Chronic Migraines

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