Ear acupuncture for anxiety in patients with COPD attending pulmonary rehabilitation: a feasibility study

Background: Pulmonary rehabilitation (PR) is the key treatment to improve physical, emotional and social functioning for patients with COPD (NICE 2010), but anxiety and depression often prevents patients gaining maximum benefit. Any therapy that reduces anxiety or depression should therefore increase effectiveness of PR. Acupuncture has been found to reduce anxiety in other groups, but its impact on COPD associated anxiety is unknown. Aim: Feasibility study of ear acupuncture (EA) as adjunctive treatment to patients with COPD attending PR programmes. Method: Patients diagnosed with COPD and referred for PR at University Hospital Southampton NHS foundation Trust, were eligible. Participants were randomised into 2 groups: Group A had real EA in the form of indwelling gold plated "seeds" at the appropriate acupuncture point; Group B had sham EA (seeds placed on an area of the ear with no known EA points). Seeds in both groups were to be pressed whenever participants felt anxious or breathless. Seeds were replaced once weekly, for six weeks. Primary Outcome: Hospital Anxiety and Depression Scale (HADS). Results: 17 participants were recruited. 1participant found EA unacceptable and withdrew. The remaining 16 participants found wearing the ear seeds acceptable. There were significant improvements from baseline to outcome in both anxiety (p=0.015) and depression (p=0.01) on HADS, within the real EA treatment group, but not the sham group. No between group differences were detected at outcome. Conclusion: Ear acupuncture was a feasible adjunctive treatment option for this sample of patients with COPD, attending PR. A larger trial is needed to confirm efficacy.