Japanese Acupuncture and Moxibustion (Online)
A survey of adverse events at acupuncture and moxibustion clinics in Japan
SHINBARA Hisashi1), OGASAWARA Chie1), HAYAMA Shinobu1), HINO Kokoro1), TANIGUCHI Hiroshi1), SUMIYA Eiji1)
1) Department of Basic Acupuncture and Moxibustion, Meiji University of Integrative Medicine
[Objective] The aim of this study was to survey the current status of adverse events (malpractice and side-effects) in clinical practices of acupuncture (Acp) and moxibustion (Mox), to discuss the problems, and to suggest corrective strategies.
[Methods] The survey was sent by mail in October 2009 to 6,000 Acp clinics (including Mox) selected at random from the i-Town-Page telephone directory. The questions addressed the following issues: (1) respondent profile; (2) Acp adverse events; (3) Mox adverse events; (4) complaints and litigation; (5) informed consent regarding these adverse events; (6) subscriptions to publications that address the safety issues of Acp and Mox; and (7) access to free
safety resources. Note that we inquired about the experiences of adverse events but did not inquire about their frequency.
[Results] The response rate was 21.6%. The top three adverse events for Acp were subcutaneous hemorrhage (65.8%), micro-hemorrhage (62.0%), and needle pain (52.9%). The top malpractice event was forgotten needles (32.7%). Needle breakage and pneumothorax, which are severe malpractice events, were reported by 2.2% and 2.0% of the clinics, respectively. The top three adverse events for Mox were accidental and unintentional burn injury (24.0%), singed hair (15.5%), and singed clothes (15.0%). The most severe malpractice event was suppuration of the Mox point (10.8%). The top adverse events associated with complaints and litigation were symptom exacerbation (21.8%) and pneumothorax (36.4%). Only 74.8% of respondents obtained informed consent, but of those, 61.0% reported providing adverse affect warnings orally. Subscriptions to books and periodicals on the safety of Acp and Mox were reported by less than 30.0% of the respondents.
[Conclusion] The most common adverse events associated with Acp were side effects caused by excessive stimulation. With Mox adverse events were more commonly attributable to negligence. The low subscription rate to safety periodicals suggests that safety information is not presently widely distributed. It is necessary to transmit safety information via the Internet as well as in books and other periodicals.