Introduction The aim of the HTA programme is to ensure that high quality research information on the effectiveness, costs and broader impact of health technologies is produced in the most efficient way for those who use, manage, provide care in or develop policy for the NHS. Topics for research are identified and prioritised to meet the needs of the NHS. Health technology assessment forms a substantial portfolio of work within the National Institute for Health Research and each year about fifty new studies are commissioned to help answer questions of direct importance to the NHS. The studies include both primary research and evidence synthesis. Question What is the clinical and cost-effectiveness of acupuncture in pregnant women with back pain, in comparison to standard care 1 Technology: A six week acupuncture package, as may plausibly be delivered in the NHS. 2 Patient group: Pregnant women with back pain (which started during pregnancy); they may also have pelvic pain. 3 Setting: Primary care / outpatient clinics (including antenatal clinics and outpatients clinics attended due to back pain). 4 Control or comparator treatment: Sham acupuncture. 5 Design: A feasibility study to assess the acceptability and design of a trial in the NHS. Methods are likely to include a survey of current practice and qualitative work with clinicians, patients and commissioners. Researchers should identify an appropriate acupuncture intervention and control. They should explore the merits of a sham acupuncture arm. 6 Important outcomes of main study: Pain. Other outcomes: Adverse events, consumption of analgesics, obstetric outcomes, absence from work, functional status, health-related quality of life, and cost-effectiveness. Outcome of the feasibility study: Outline plan for a randomised controlled study with evidence supporting its design and delivery. 7 Minimum duration of follow-up of main study: Six months after delivery. Background to commissioning brief: Back pain is reported to affect at least 75% of women at some stage during their pregnancy. The pain can result in significant morbidity. Disability often prevents simple activities of daily living (disturbed sleep, endurance capacity for standing, walking, and sitting is diminished) and can result in significant absenteeism from work. Two rigorously conducted systematic reviews have been published evaluating the effect of acupuncture to treat pelvic and back pain in pregnancy. The findings from the review of Ee 2008 were consistent with Pennick 2007, which included the same randomised controlled trials. Overall, the findings from the reviews highlight promising evidence for the effectiveness of acupuncture to manage back and pelvic pain and suggest the need to conduct further high-quality trials.
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73110000, 73210000, 85140000
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