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Patient reports of adverse events associated with acupuncture treatment: a prospective national survey
  1. H MacPherson1,
  2. A Scullion1,
  3. K J Thomas2,
  4. S Walters3
  1. 1Foundation for Traditional Chinese Medicine, York, UK
  2. 2Medical Care Research Unit, University of Sheffield, Sheffield, UK
  3. 3Sheffield Health Economics Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
  1. Correspondence to:
 Dr H MacPherson
 Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK;


Objective: The primary aim was to establish from acupuncture patients the type and frequency of adverse events they experienced and attributed to their treatment. Secondary aims included the measurement of patient reported adverse consequences arising from advice received about conventional/prescribed medication or from delayed conventional diagnosis and treatment.

Methods: Postal survey of prospectively identified acupuncture patients. One in three members of the British Acupuncture Council (n = 638) invited consecutive patients to participate in the survey. Participating patients gave baseline data and consented to direct follow up by the researchers at 3 months. A structured questionnaire was used to collect data on perceived adverse events.

Results: 9408 patients gave baseline information and consent and 6348 (67%) completed 3 month questionnaires. Responders were not dissimilar to non-responders for all known characteristics. 682 patients reported at least one adverse event over 3 months, a rate of 107 per 1000 patients (95% CI 100 to 115). Three patients reported a serious adverse event. The most common events reported were severe tiredness and exhaustion, pain at the site of needling, and headache. Patients receiving acupuncture treatment that was not funded by the NHS and patients not in contact with a GP or hospital specialist were less likely to report adverse events (odds ratios 0.59 and 0.66, respectively). 199 (3%) of responding patients reported receiving advice about conventional/prescribed medication, six of whom reported adverse consequences after taking the advice. Two patients reported delayed conventional treatment.

Conclusion: Patients report a range of adverse events but these do not prevent most patients seeking further acupuncture. This large scale survey supports existing evidence that acupuncture is a relatively safe intervention when practised by regulated practitioners.

  • acupuncture
  • adverse events
  • patient safety
  • patient reports

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  • HM initiated the project, coordinated all aspects of the study, and is the guarantor. KJT and SW contributed to study design, data analysis, interpretation of results, and manuscript drafting. TS managed the day-to-day work of mailings, data inputting, and much data analysis. Julie Elrick assisted in the early stages of the project and in piloting the documentation. Trevor Sheldon helped in the final drafting the manuscript. External scientific advisors included Alan Bensoussan, Stephen Birch, Alan Breen, Roy Carr-Hill, Mike Fitter, Charles Vincent and Adrian White. The study was supported by a grant from the British Acupuncture Council.

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