Defining the details of acupuncture treatment for pelvic pain in endometriosis: a systematised literature review and an e-Delphi study

By Nora Giese - Online MSc - Advanced Oriental Medicine

Abstract

Background

Growing evidence suggests that acupuncture can improve pelvic pain in women with endometriosis. As treatment details used in research differ, it remains unclear which treatment is recommended for clinical practice.

Aims and objectives

This research project aimed to define how acupuncture should be used in treating pelvic pain in endometriosis. It comprised two phases, a systematised literature review to extract acupuncture treatment details from published research and an e-Delphi study to gain knowledge about details as used by expert acupuncturists.

Methodology

Review: Four databases were searched using predefined inclusion/exclusion criteria. Data were extracted based on the STRICTA criteria. E-Delphi: Recruitment for the e-Delphi consisted of purposeful sampling found by personal acquaintances, recommendations, internet search, and snowballing. An open first round gathered qualitative data, analysed with the Framework method. In rounds two and three, experts rated statements to build group consensus, defined as a rating of ≥ five on a 7-point Likert scale by ≥70% of the experts. The strength of agreement was graded using the median score and interquartile range. Results from the systematised literature review and the e-Delphi were compared using the STRICTA items.

Findings

The systematised literature review (n=29 unique studies) found a wide range of treatment details with little agreement. The e-Delphi of international experts (n=20) resulted in agreement on 94 statements (such as key factors for effectivity: additional use of Chinese herbal medicine and dietary recommendations), lack of consensus on 55 statements (such as the number of needle insertions per subject per session), and disagreement on another 29(like acupuncture sessions three times a week). Comparison of the review and e-Delphi results found little agreement on treatment details.

Conclusion

Details of acupuncture treatment for endometriosis-related pelvic pain as used in studies and by expert acupuncturists were presented. Their effectiveness should be evaluated in future research.

Read Nora's article in Science Direct