Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial
Publication Date
September 24, 2013
Journal
PLOS Medicine
Authors
Hugh Mac Pherson, Stewart Richmond, Martin Bland, Stephen Brealey, et al
Volume
10
Issue
9
Pages
e1001518
DOI
http://doi.org/10.1371/journal.pmed.1001518
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1001518
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/24086114
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782410
Europe PMC
http://europepmc.org/abstract/MED/24086114
Web of Science
000324863700013
Scopus
84884667625
Mendeley
http://www.mendeley.com/research/acupuncture-counselling-depression-primary-care-randomised-controlled-trial
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Mendeley | Further Information

{"title"=>"Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial", "type"=>"journal", "authors"=>[{"first_name"=>"Hugh", "last_name"=>"MacPherson", "scopus_author_id"=>"7006062923"}, {"first_name"=>"Stewart", "last_name"=>"Richmond", "scopus_author_id"=>"24382167500"}, {"first_name"=>"Martin", "last_name"=>"Bland", "scopus_author_id"=>"7202273887"}, {"first_name"=>"Stephen", "last_name"=>"Brealey", "scopus_author_id"=>"6701382260"}, {"first_name"=>"Rhian", "last_name"=>"Gabe", "scopus_author_id"=>"16233182600"}, {"first_name"=>"Ann", "last_name"=>"Hopton", "scopus_author_id"=>"36155495300"}, {"first_name"=>"Ada", "last_name"=>"Keding", "scopus_author_id"=>"36080578300"}, {"first_name"=>"Harriet", "last_name"=>"Lansdown", "scopus_author_id"=>"23967874700"}, {"first_name"=>"Sara", "last_name"=>"Perren", "scopus_author_id"=>"7102084277"}, {"first_name"=>"Mark", "last_name"=>"Sculpher", "scopus_author_id"=>"7006749329"}, {"first_name"=>"Eldon", "last_name"=>"Spackman", "scopus_author_id"=>"15063411100"}, {"first_name"=>"David", "last_name"=>"Torgerson", "scopus_author_id"=>"7102422382"}, {"first_name"=>"Ian", "last_name"=>"Watt", "scopus_author_id"=>"7102570285"}], "year"=>2013, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-84884667625", "sgr"=>"84884667625", "pui"=>"369899161", "isbn"=>"1549-1676", "pmid"=>"24086114", "doi"=>"10.1371/journal.pmed.1001518"}, "id"=>"52c21765-305c-3f09-af9b-934e1755d8d5", "abstract"=>"BACKGROUND: Depression is a significant cause of morbidity. Many patients have communicated an interest in non-pharmacological therapies to their general practitioners. Systematic reviews of acupuncture and counselling for depression in primary care have identified limited evidence. The aim of this study was to evaluate acupuncture versus usual care and counselling versus usual care for patients who continue to experience depression in primary care. METHODS AND FINDINGS: In a randomised controlled trial, 755 patients with depression (Beck Depression Inventory BDI-II score >/= 20) were recruited from 27 primary care practices in the North of England. Patients were randomised to one of three arms using a ratio of 2.2.1 to acupuncture (302), counselling (302), and usual care alone (151). The primary outcome was the difference in mean Patient Health Questionnaire (PHQ-9) scores at 3 months with secondary analyses over 12 months follow-up. Analysis was by intention-to-treat. PHQ-9 data were available for 614 patients at 3 months and 572 patients at 12 months. Patients attended a mean of ten sessions for acupuncture and nine sessions for counselling. Compared to usual care, there was a statistically significant reduction in mean PHQ-9 depression scores at 3 months for acupuncture (-2.46, 95% CI -3.72 to -1.21) and counselling (-1.73, 95% CI -3.00 to -0.45), and over 12 months for acupuncture (-1.55, 95% CI -2.41 to -0.70) and counselling (-1.50, 95% CI -2.43 to -0.58). Differences between acupuncture and counselling were not significant. In terms of limitations, the trial was not designed to separate out specific from non-specific effects. No serious treatment-related adverse events were reported. CONCLUSIONS: In this randomised controlled trial of acupuncture and counselling for patients presenting with depression, after having consulted their general practitioner in primary care, both interventions were associated with significantly reduced depression at 3 months when compared to usual care alone. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN63787732 Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/acupuncture-counselling-depression-primary-care-randomised-controlled-trial", "reader_count"=>193, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>5, "Librarian"=>4, "Student > Doctoral Student"=>6, "Researcher"=>14, "Student > Ph. D. 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  • {"files"=>["https://ndownloader.figshare.com/files/1214301"], "description"=>"<p>Percent given out of non-missing data, percent missing given out of applicable group total.</p><p>A BDI-II score of 20 or above was required to be eligible for the trial.</p>", "links"=>[], "tags"=>["variables"], "article_id"=>807125, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.t001", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographics_and_variables_of_interest_at_bastline_/807125", "title"=>"Demographics and variables of interest at bastline.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214300"], "description"=>"a<p>ANCOVA, effect of trial arm on imputed PHQ-9 at 3 months (adjusting for baseline PHQ-9).</p>b<p>Mixed, effect of trial arm on PHQ-9 over 12 months, (mixed effects model, including time, trial arm x time, baseline PHQ-9, baseline expectation of counselling and baseline expectation of allocated treatment. For the comparison between acupuncture and counselling, treatment time by 3 months and practitioner's empathy were additionally included.)</p>c<p>AUC, effect of trial arm on average PHQ-9 depression over 12 months (adjusting for Baseline PHQ-9).</p><p>SE, standard error.</p>", "links"=>[], "tags"=>["phq-9"], "article_id"=>807124, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.t003", "stats"=>{"downloads"=>0, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_trial_arm_on_PHQ_9_depression_/807124", "title"=>"Effect of trial arm on PHQ-9 depression.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214297"], "description"=>"<p>CONSORT flow diagram.</p>", "links"=>[], "tags"=>[], "article_id"=>807121, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.g001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_CONSORT_flow_diagram_/807121", "title"=>"CONSORT flow diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214306", "https://ndownloader.figshare.com/files/1214307", "https://ndownloader.figshare.com/files/1214308", "https://ndownloader.figshare.com/files/1214310", "https://ndownloader.figshare.com/files/1214311", "https://ndownloader.figshare.com/files/1214312", "https://ndownloader.figshare.com/files/1214313", "https://ndownloader.figshare.com/files/1214314", "https://ndownloader.figshare.com/files/1214315", "https://ndownloader.figshare.com/files/1214316"], "description"=>"<div><p>Background</p><p>Depression is a significant cause of morbidity. Many patients have communicated an interest in non-pharmacological therapies to their general practitioners. Systematic reviews of acupuncture and counselling for depression in primary care have identified limited evidence. The aim of this study was to evaluate acupuncture versus usual care and counselling versus usual care for patients who continue to experience depression in primary care.</p><p>Methods and Findings</p><p>In a randomised controlled trial, 755 patients with depression (Beck Depression Inventory BDI-II score ≥20) were recruited from 27 primary care practices in the North of England. Patients were randomised to one of three arms using a ratio of 2∶2∶1 to acupuncture (302), counselling (302), and usual care alone (151). The primary outcome was the difference in mean Patient Health Questionnaire (PHQ-9) scores at 3 months with secondary analyses over 12 months follow-up. Analysis was by intention-to-treat.</p><p>PHQ-9 data were available for 614 patients at 3 months and 572 patients at 12 months. Patients attended a mean of ten sessions for acupuncture and nine sessions for counselling. Compared to usual care, there was a statistically significant reduction in mean PHQ-9 depression scores at 3 months for acupuncture (−2.46, 95% CI −3.72 to −1.21) and counselling (−1.73, 95% CI −3.00 to −0.45), and over 12 months for acupuncture (−1.55, 95% CI −2.41 to −0.70) and counselling (−1.50, 95% CI −2.43 to −0.58). Differences between acupuncture and counselling were not significant. In terms of limitations, the trial was not designed to separate out specific from non-specific effects. No serious treatment-related adverse events were reported.</p><p>Conclusions</p><p>In this randomised controlled trial of acupuncture and counselling for patients presenting with depression, after having consulted their general practitioner in primary care, both interventions were associated with significantly reduced depression at 3 months when compared to usual care alone.</p><p>Trial Registration</p><p>Controlled-Trials.com <a href=\"http://www.controlled-trials.com/ISRCTN63787732/ISRCTN63787732\" target=\"_blank\">ISRCTN63787732</a></p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["counselling", "randomised", "controlled"], "article_id"=>807129, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001518.s001", "https://dx.doi.org/10.1371/journal.pmed.1001518.s002", "https://dx.doi.org/10.1371/journal.pmed.1001518.s003", "https://dx.doi.org/10.1371/journal.pmed.1001518.s004", "https://dx.doi.org/10.1371/journal.pmed.1001518.s005", "https://dx.doi.org/10.1371/journal.pmed.1001518.s006", "https://dx.doi.org/10.1371/journal.pmed.1001518.s007", "https://dx.doi.org/10.1371/journal.pmed.1001518.s008", "https://dx.doi.org/10.1371/journal.pmed.1001518.s009", "https://dx.doi.org/10.1371/journal.pmed.1001518.s010"], "stats"=>{"downloads"=>59, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Acupuncture_and_Counselling_for_Depression_in_Primary_Care_A_Randomised_Controlled_Trial_/807129", "title"=>"Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214303"], "description"=>"a<p>All percentages given out of total number of patients with valid responses.</p>", "links"=>[], "tags"=>["patients", "taking", "prescribed", "preceding"], "article_id"=>807127, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.t005", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_patients_taking_prescribed_medication_in_the_preceding_3_months_/807127", "title"=>"Number of patients taking prescribed medication in the preceding 3 months.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214302"], "description"=>"a<p>ANCOVA, effect of trial arm on imputed BDI-II at 12 months (adjusting for baseline BDI-II, baseline expectation of counselling and baseline expectation of allocated treatment. For the comparison between acupuncture and counselling, treatment time by 3 months and practitioner's empathy were additionally included.)</p>", "links"=>[], "tags"=>["bdi-ii"], "article_id"=>807126, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.t004", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_trial_arm_on_BDI_II_depression_/807126", "title"=>"Effect of trial arm on BDI-II depression.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214299"], "description"=>"<p>Unadjusted depression outcomes.</p>", "links"=>[], "tags"=>[], "article_id"=>807123, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.t002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_depression_outcomes_/807123", "title"=>"Unadjusted depression outcomes.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-09-24 01:28:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1214298"], "description"=>"<p>Acupuncture, black line; counselling, grey line; usual care, dashed line.</p>", "links"=>[], "tags"=>["phq-9", "scores", "baseline", "12"], "article_id"=>807122, "categories"=>["Biological Sciences"], "users"=>["Hugh MacPherson", "Stewart Richmond", "Martin Bland", "Stephen Brealey", "Rhian Gabe", "Ann Hopton", "Ada Keding", "Harriet Lansdown", "Sara Perren", "Mark Sculpher", "Eldon Spackman", "David Torgerson", "Ian Watt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001518.g002", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_PHQ_9_mean_scores_from_baseline_to_12_months_/807122", "title"=>"Unadjusted PHQ-9 mean scores from baseline to 12 months.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-09-24 01:28:30"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Complementary and alternative medicine", "average_usage"=>[358, 596, 798, 985, 1118, 1258, 1372, 1479, 1601, 1800, 1922, 2031, 2171, 2280]}, {"subject_area"=>"/Medicine and health sciences/Pharmacology", "average_usage"=>[265, 471, 604, 723, 827, 926, 1022, 1113, 1210, 1290, 1377, 1454, 1532]}]}

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