Acupuncture in the emergency department: A retrospective evaluation of patient-reported outcomes and healthcare utilization

OBJECTIVE: To examine outcomes following acupuncture as a nonpharmacologic option in emergency departments during real-world implementation. METHODS: We conducted a retrospective analysis of a quality improvement program offering acupuncture to adult emergency department patients in 2023 across three intervention sites. Controls were drawn from the same emergency departments in 2022 and from matched nonparticipating emergency departments in 2022-2023. We used propensity score matched difference-in-differences models to estimate the average treatment effect on the treated for admission pain change. Secondary outcomes included emergency department analgesic-related discharge prescriptions and 30-day emergency department return or inpatient admissions. Intervention patients reported on pain, anxiety, stress and nausea before and after treatment and completed a brief post-treatment satisfaction survey. RESULTS: The matched analytic sample included 358 intervention and 2702 matched control encounters. Acupuncture was associated with greater admission pain reduction (average treatment effect on the treated -1.35; 95% confidence interval -1.84 to -0.85). Among intervention patients, the pre- to post-acupuncture pain change averaged 2.4 points on a 0-10 numerical rating scale. There were no differences in discharge opioid or non-opioid prescriptions and no differences in 30-day emergency department returns or inpatient admissions. Satisfaction was high (with 98% indicating they would receive acupuncture again) and 64% stated they would pay out of pocket. Patients reported significant reductions in anxiety, stress and nausea following acupuncture. CONCLUSIONS: In real-world emergency department implementation, acupuncture was feasible and acceptable, and was associated with clinically meaningful within-patient symptom relief and a statistically significant incremental improvement in admission pain compared with usual care. High satisfaction and improvements in anxiety, stress and nausea indicate potential added patient-centered value beyond pain management.