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Acupuncture for Non-cardiac Chest Pain Project
| Patients with chest pain commonly present in
primary care, followed by referral to cardiac clinics in secondary care. However as many
as 50% of patients referred to such cardiac clinics are found to have not to have a
cardiac-related problem. The causes of
non-cardiac chest pain are not always clear, however there is evidence that they could be
musculo-skeletal, gastro-intestinal, respiratory or psychiatric, the commonest cause being
musculo-skeletal. Non-cardiac patients are usually referred back to primary care, where
they often continue to experience chest pain, with as many as three-quarters experiencing
limitations in activities, concern about the cause of their symptoms and dissatisfaction
with medical care. Acupuncture is increasingly being used to treat non-cardiac chest pain
despite limited evidence of its effectiveness. |
Key publications:
Dumville
JC, MacPherson H, Griffith K, Miles JN, Lewin RJ. Non-cardiac chest pain:
a retrospective cohort study of patients who attended a Rapid Access Chest Pain
Clinic. Fam Pract. 2007; 24(2):152-7.[Full
text]
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We are undertaking this research in two phases. In
the first phase we have conducted a survey of patients with chest pain that has not been
diagnosed as cardiac in origin following their visit to York Hospital’s Rapid Access
Chest Pain Unit. The survey have captured vital information about this population including their diagnosis and treatment to date, their current chest pain levels, and if
still in pain, their interest in receiving acupuncture. In this first phase, our
collaborators have included Dr Kathryn Griffith, a GP and Clinical Assistant in Cardiology
at the York District Hospital where she works at the Rapid Access Chest Pain Clinic two
days a week, and, from the University of York, Bob Lewin, Professor of Cardiac
Rehabilitation, Martin Bland, Professor of Health Statistics, Professor David Torgerson,
Director of the York Trials Unit and Senior Research Fellow Dr Jo Dumville. The results of this survey
have recently been published. [Dumville
et al 2007, MacPherson
& Dumville 2007]
Our second phase, which will be informed by the
data from the first phase, will be a pilot for a pragmatic randomised controlled trial of
acupuncture for non-cardiac chest pain. In turn this second phase will provide a platform for us
to design and apply for funding for a large-scale randomised, controlled study to
determine acupuncture’s potential as a treatment for non-cardiac chest pain.
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