Authors' objectives: To evaluate the efficacy, safety and cost-effectiveness related to acupuncture for neurological disorder; headache, refractory neuralgia, Bell’s palsy, post-stroke, Guillain Barre and transverse myelitis.

Authors' results and conclusions: There was substantial evidence on acupuncture on headache, Bell’s palsy and post-stroke. However, most of the studies have high risk of bias due to inappropriate randomised sequence generation, lack of allocation concealment, inadequate level of blinding, poor description of patient withdrawals from the studies and the adverse events and hence, varying the quality of the included trials. Nevertheless, the evidence showed that acupuncture may reduce headache frequency and improve response rate to treatment. The evidence was inconclusive for Bell’s palsy. As for post-stroke patients, the evidences showed acupuncture may improve ADL. As for other outcomes means, the results were inconclusive. For refractory neuralgia, Guillain Barre and transverse myelitis, there was insufficient evidence to assess the efficacy of acupuncture in these group patients. There were studies reported on adverse events namely, haematoma and ecchymosis, migraine attacks and headache after treatment, pain and fatigue, seizure, and stomach discomfort. Meanwhile, none of the clinical trials reported any serious adverse events. Acupuncture was approved by United States of Food and Drug Administration (USFDA) in 1996 and classified as Class II (special control). In term of cost-effectiveness, acupuncture was suggested to be clinically relevant benefit and cost-effective in certain sectors. In Malaysia, the cost per session varies according to scope of treatment ranges between RM35 to RM315. However, acupuncture service is being provided for RM20 per session at Traditional and Complementary Medicine Unit in Ministry of Health hospitals as per Perintah Fi (Perubatan) (Pindaan) 2017.

Authors' recommendations: Acupuncture may be used as an adjunct treatment to reduce headache severity and improve symptoms in post-stroke patient.

Authors' methods: Electronic databases were searched through the Ovid interface; Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present EMBASE - 1946 to April 17 2020, EBM Reviews – Health Technology Assessment 4th Quarter 2016, EBM Reviews – Cochrane Database of Systematic Reviews 2005 to May 1, 2020, EBM Reviews – Cochrane Central Register of Controlled Trials March 2020, EBM Reviews – Database of Abstracts of Review of Effects 1st Quarter 2016, EBM Reviews – NHS Economic Evaluation Database 1st Quarter 2016. Searches were also run in PubMed, INAHTA and US FDA. Google was used to search for additional web-based materials and information. Additional articles were identified from reviewing the references of retrieved articles. Last search was conducted on 6 May 2020

Project Status: Completed

Year Published: 2020

URL for published report: https://www.moh.gov.my/index.php/database_stores/store_view_page/30/358

Requestor: Decision making committee

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment Section (MaHTAS)