Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: An open, prospective study

Objectives: A cost-benefit analysis of acupuncture and self-care education in the treatment of patients with angina pectoris. Design: An open prospective study on an unselected group of patients. For comparison of risk three control groups were used: (1) published data concerning medical and invasive treatments; (2) an age- and sex matched group obtained from a randomly selected Danish population of 14,000 people; and (3) the 211 patients in this group with angina pectoris symptoms. Setting: The treatment was carried out on a outpatient basis in a private research clinic. Subjects: 105 patients with angina pectoris, 73 candidates for invasive treatment, and 32 for whom this was rejected. Interventions: Acupuncture and self-care education was added to the pharmaceutical treatment. Outcome measures: Healthcare expenses, a satisfactory medical status defined as New York Heart Association (NYHA) classification 0-I and/or no use of antianginal medication, and risk measured as cardiac death or myocardial infarction. Results: The estimated cost savings during 5 years were $32,000 (U.S.) per patient, mainly due to a 90% reduction in hospitalization and 70% reduction in needed surgery. Compared to 8% before treatment, 53% of the patients achieved a life without limitations (NYHA 0-I) 1 year after treatment, as did 69% after 5 years. No increased risk for myocardial infarction or cardiac death was observed. Conclusions: The addition of acupuncture and self-care education was found to be cost beneficial in patients with advanced angina pectoris. The results invite further testing in a randomized controlled trial.