Is acupuncture a feasible, safe, and acceptable treatment for overactive bladder (OAB) symptoms? An exploration using a mixed methods design.

Hargreaves, Katharine Emma (2024) Is acupuncture a feasible, safe, and acceptable treatment for overactive bladder (OAB) symptoms? An exploration using a mixed methods design. Doctoral thesis, Northumbria University.

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Abstract

Overactive bladder (OAB) is a common complaint, 1 in 9 of the adult population in the UK have symptoms. Three key symptoms lead to diagnosis, urinary urgency, frequency and nocturia, often accompanied by urinary incontinence. OAB has a profound effect on quality of life and is linked with anxiety and depression.

OAB is under-diagnosed, treatments have known side effects, and some are invasive and costly. Acupuncture has been suggested as an alternative treatment and some evidence supports its further investigation. Limited work has been conducted in the UK and there is a dearth of patient experience studies worldwide.

This thesis addresses the knowledge gap utilising a mixed methods research model based on the Medical Research Council’s framework for complex interventions. It consists of a comprehensive review of the pathophysiology of OAB and treatment strategies; a Cochrane Interventional Review of acupuncture to treat OAB; a feasibility study to test the delivery, safety and acceptability of acupuncture; and a qualitative study investigating patient’s experiences of having acupuncture for their symptoms.

Possible causes of OAB are likely to be individual and multi-faceted. The Cochrane Review provided low certainty evidence that acupuncture may be more effective than medication for OAB, with a lower adverse event profile. However, the risk of bias in studies was high. There was no evidence found regarding the cost effectiveness of acupuncture for OAB. Feasibility of delivering acupuncture in a secondary care NHS setting was demonstrated, but the patient experience information collected lacked detail. The qualitative interview study rectified this gap. The themes developed demonstrated the profound effects of OAB on life experience and were overwhelmingly supportive of the use of acupuncture.

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