Acupuncture in the real world: evaluating a 15-year NADA auricular acupuncture service for breast cancer survivors experiencing hot flushes and night sweats as a consequence of adjuvant hormonal therapies
Beverley de Valois1,2, Teresa Young3, Pam Thorpe4, Tarsem Degun4, Karen Corbishley4
1 Supportive Oncology Research Team, East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, Middlesex, UK. firstname.lastname@example.org.
2 Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK. email@example.com.
3 Supportive Oncology Research Team, East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, Middlesex, UK.
4 Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, Middlesex, UK.
Purpose: While clinical trials provide valuable data about efficacy of interventions, findings often do not translate into clinical settings. We report real world clinical outcomes of a 15-year service offering breast cancer survivors auricular acupuncture to manage hot flushes and night sweats (HFNS) associated with adjuvant hormonal treatments. This service evaluation aims to (1) assess whether usual practice alleviates symptoms in a clinically meaningful way and (2) compare these results with scientific evidence.
Methods: Data were analysed from 415 referrals to a service offering women eight standardised treatments using the National Acupuncture Detoxification Association (NADA) protocol. Outcome measures administered at baseline, end of treatment (EOT), and 4 and 18 weeks after EOT included hot flush diaries, hot flush rating scale (HFRS) and women's health questionnaire (WHQ).
Results: Over 2285 treatments were given to 300 women; 275 (92.3%) completed all eight treatments. Median daily frequency of HFNS reduced from 9.6 (IQR 7.3) to 5.7 (IQR 5.8) at EOT and 6.3 (IQR 6.5) 18 weeks after EOT. HFRS problem rating showed a clinically meaningful reduction of ≥ 2 points at all measurement points. WHQ showed improvements in several symptoms associated with the menopause. Two adverse events were reported, neither were serious. Results are comparable to published research.
Conclusion: This first analysis of a long-term auricular acupuncture service compares favourably with outcomes of other studies for reducing HFNS frequency and associated menopausal symptoms. In day-to-day clinical practice, NADA appears to be a safe effective intervention for breast cancer survivors.