1 / 17

Acupuncture for Hemophilia Patients in Chronic Pain.

Acupuncture for Hemophilia Patients in Chronic Pain. Angela Lambing, MSN, NP-C, 1 Dr. Vinay Varma, 2 Beth Kohn L.Ac., M.T.O.M, Dipl.Ac, Dipl.CH , 1 Dr. Suresh Hanagavadi 2 1 Henry Ford Health System, Detroit, MI 2 Karnataka Hemophilia Society, India. Statement of the Problem.

amaya-goodwin
Download Presentation

Acupuncture for Hemophilia Patients in Chronic Pain.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Acupuncture for Hemophilia Patients in Chronic Pain. Angela Lambing, MSN, NP-C, 1 Dr. Vinay Varma, 2 Beth KohnL.Ac., M.T.O.M, Dipl.Ac, Dipl.CH, 1 Dr. Suresh Hanagavadi2 1Henry Ford Health System, Detroit, MI 2Karnataka Hemophilia Society, India

  2. Statement of the Problem • Chronic pain due to end stage arthritis for hemophilia patients presents ongoing issues resulting in exploration of non-standard therapies for pain management • Acupuncture has proved successful in osteoarthritis and non-malignant pain. • Pain management involves a multimodal approach

  3. Objectives • This study seeks to: • a) Document a decrease in hemarthritic joint pain after acupuncture treatments • b) Demonstrate minimal bleeding risk during acupuncture.

  4. Review of the Literature Minimal literature related to hemophilia • Wallny TA, Brackmann, HH, Gunia G, WIlbertz P, Oldenberg J, Kraft CN. (2006). Successful pain treatment in arthropathic lower extremities by acupuncture in haemophilia patients. Haemophilia. 12(5); 500-2. • 10/12 pts showed improvement • Average VAS reduced from 6.8/10 to 5/10 • No side effects were observed

  5. Rosted P & Jorgensen V. (2002). Acupuncture used in the management of pain due to arthropathy in a patient with haemophilia. Acupuncture medicine. 20(4); 193-5. • Case report – 38 yr old severe hemophilia A, with joint pain; knees, elbows, ankles • On factor prophylaxis; received factor prior to tx • Previous right knee synovectomy • 5 tx for the knee with reported significant reduction in pain • Repeat acupuncture every 3 months • Close collaboration with hemophilic clinic • Use of qualified acupuncture specialists

  6. Method • Convenience sample • Prospective study • Dual study between Twinning partners: • Henry Ford Health System, Detroit, MI • Karnataka Hemophilia Society, Karnataka, India • Utilized certified acupuncturists • Inclusion Criteria • > 18 years of age • Hemophilia • Reported chronic pain • Severe Joint hemarthrosis as identified by the HTC • Michigan subjects – factor replacement > 15% level (per IRB requirements) • India residents – no factor prior to treatments

  7. Acupuncture points • Acupuncture treatment plan • Twice per week x 4 weeks; weekly for remaining 6 weeks Primary acupuncture points: • Du 20, LI 4, Liv 3, Gb 34, Sp 6, LI 11, St 35, Kid 3, Shen Men Ear Point • Specific Knee pain: • Secondary points: Xi yan, Heding, Liv 8, Sp 10 • Specific Ankle pain: • Secondary Points: St 41, Gb 40, Sp5 • Specific Lower back pain: • Secondary Points: Ub 23, Du 4 • Specific Elbow Pain: • Secondary Points: Lu 5, Sj 5

  8. Method • Measured pain scores using: • Visual analog scale: 0 – 10 • Average daily pain • Highest level • Lowest level • Types of pain medications utilized • Number of pain pills taken/day • Quality of Life (QOL) • Standard SF-36

  9. Method • Signed consent per IRB protocol • Cost of acupuncture sessions covered • Mileage covered for travel to each session • Patients were instructed to report any bleeding issues • Acupuncturists identified any post procedural bleeding issues.

  10. Results • 19 HFH hemophilia pts signed up to participate • Only 6 completed the study citing travel & work restrictions • 3 hemophilia pts completed study in India • Total of 9 pts completed study • 6 severe hemophilia • 2 moderate hemophilia • 1 mild hemophilia

  11. Ethnicity: 3 India 4 Caucasian 2 Afr American Education: 4 college 2 secondary school 2 technical school 1 grade school: gr 8 Marital Status 7 married 2 single Age: 28 – 63 yrs Ave age 45 years Work 4 full time 3 disabled 1 student 1 retired Demographics

  12. Pain level reports: VAS 0-10

  13. SF-36; QOL scores

  14. Pre Acupuncture Post Acupuncture

  15. Pre Acupuncture Post Acupuncture

  16. Limitations • Very small sample size • Duration of therapy program proved a barrier to enrollment • Additional objective data to confirm improvement would have been helpful • Joint measurements

  17. Conclusions • No bleeding experienced: • With any subject • After every treatment session • Factor vs no factor pre treatment • 6/8 pts reported decrease in VAS pain scores • 7/9 QOL domains improved • Alternative therapies: acupuncture may provide some benefit to chronic pain patients with hemophilia in a multimodal approach • Larger randomized studies are needed

More Related