The interpretation of the results for clinical practice says 33% of acupuncture for depression patients, 29% of counseling patients and 18% of usual care patients achieved a successful treatment showing improvement in their depression. The number of treatments needed is also a useful way to interpret results. The study found that the number of treatments was 7 for acupuncture and 10 for counseling. A further illustration of the impact on patient experience can be provided in terms of ‘depression-free days’, The mean number of depression-free days over 3 months was 34 for the acupuncture for depression group, 27 for the counseling group and 23 for the usual care group.
The trial did not determine whether acupuncture or counseling performed better or worse for the more mild forms of depression. The trial also did not determine whether or not patients not receiving antidepressant medication do better or whether fewer sessions would be sufficient for mild to moderate depression or more sessions would improve outcomes for those with severe depression.
Patients commonly reported that their acupuncturists appeared to have a more physical perspective on treatment, with a focus on directly relieving the symptoms of depression as well as concurrent physical symptoms. This was particularly welcomed by patients who appreciated having their physical symptoms treated alongside their depression.
Participants in the pain group had greater reductions in depression symptoms with acupuncture from baseline to 12 months than those who received counseling or usual care. Participants in the pain group receiving acupuncture found that their pain reduced markedly in the first 3–6 months compared with those in the other two groups. That patients reported reduced pain following acupuncture is not surprising given that 32% of patients had chronic musculoskeletal pain and acupuncturists within the trial were encouraged to work how they normally would, incorporating treatment for pain alongside treatment for the symptoms of depression. Moreover, there is a growing body of evidence supporting the efficacy of acupuncture for chronic pain.
In this report they present what is to our knowledge the first study to rigorously evaluate the clinical and economic impacts of acupuncture for depression and counseling for patients who are representative of those who continue to experience depression in primary care. Our evidence on acupuncture compared with usual care and counseling compared with usual care shows that both treatments are associated with a statistically significant reduction in symptoms of depression in the short to medium term, with no reported serious adverse events related to treatment. Acupuncture is cost-effective compared with counseling or usual care alone, although the ranking of counseling and acupuncture depends on the relative costs of delivering these interventions