Cost-effectiveness of acupuncture versus standard care for pelvic and low bac...

WTW

Abstract

Objective: To assess the cost-effectiveness of acupuncture for pelvic girdle and low back pain (PGLBP) during pregnancy.

Design: Pragmatic-open-label randomised controlled trial.

Setting: Five maternity hospitals.

Population: Pregnant women with PGLBP.

Method: 1:1 randomization to standard care or standard care plus acupuncture (5 sessions by an acupuncturist midwife).

Main outcome measure: Efficacy: proportion of days with self-assessed pain by numerical rating scale (NRS) ≤ 4/10. Cost effectiveness (societal viewpoint, time horizon: pregnancy): incremental cost per days with NRS ≤ 4/10. Indirect non-healthcare costs included daily compensations for sick leave and productivity loss caused by absenteeism or presenteeism.

Results: 96 women were allocated to acupuncture and 103 to standard care (total 199). The proportion of days with NRS ≤ 4/10 was greater in the acupuncture group than in the standard care group (61% vs 48%, p = 0.007). The mean Oswestry disability score was lower in the acupuncture group than with standard care alone (33 versus 38, Δ = 5, 95% CI: 0.8 to 9, p = 0.02). Average total costs were higher in the control group (