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Author (up) Sherman, K. J.; Cherkin, D. C.; Ichikawa, L.; Avins, A. L.; Delaney, K.; Barlow, W. E.; Khalsa, P. S.; Deyo, R. A. url  openurl
  Title Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain Type of Study RCT
  Year 2010 Publication Spine Abbreviated Journal Spine (Phila Pa 1976)  
  Volume 35 Issue 15 Pages 1471-1477  
  Keywords AcuTrials; RCT; Back Pain; Low Back Pain, Chronic; Pain; Acu Versus > 1 Control; Acu Versus CAM Control; Acu Versus Acu; Acupuncture; TCM Acupuncture Style; Individualized Acupuncture Protocol; Traditional Diagnosis Based Point Selection; Fixed Acupuncture Protocol; Restricted Modalities, Acupuncture Only; Sham Control; Non Penetrating Sham, Mechanical; Verum Acupoint Control; CAM Control; Usual Care Control, Unspecified; Treatment Expectations;  
  Abstract STUDY DESIGN: Preplanned secondary analysis of data from participants receiving acupuncture in a randomized clinical trial. OBJECTIVE: To determine whether patients' expectations of and preferences for acupuncture predict short and long-term treatment outcomes for persons with chronic back pain. SUMMARY OF BACKGROUND DATA: Although accumulating evidence suggests that patient expectations and treatment preferences may predict treatment outcomes, few studies have examined this relationship for acupuncture. METHODS: Four hundred seventy-seven acupuncture-naive participants with chronic low back pain who were randomized to 1 of 3 acupuncture or simulated acupuncture treatments were the focus of this analysis. Ten treatments were provided during a 7-week period, and participants were masked to treatment assignment. Before randomization, participants provided expectations regarding treatment success, impressions, and knowledge about acupuncture and treatment preferences. Outcomes of interest were functional status (Roland score) and symptom bothersomeness at 8 and 52 weeks postrandomization, obtained by telephone interviewers masked to treatment assignment. RESULTS: Persons with high pretreatment expectations for the success of acupuncture were more likely to report greater general expectations for improvement, a preference for acupuncture, having heard acupuncture was a very effective treatment and having a very or moderately positive impression of acupuncture. However, none of these variables was a significant predictor of improvement in back-related symptoms or function at 8 or 52 weeks. After 1 treatment, participants' revised expectations of treatment success were only associated with back-symptoms at the end of treatment. After 5 treatments, revised expectation of success was predictive of both symptoms and function at 8 and 52 weeks. CONCLUSION: Pretreatment expectations and preferences for acupuncture were not found predictive of treatment outcomes for patients with chronic back pain. These results differ from previous studies evaluating acupuncture for chronic back pain. These inconsistent results suggest that the relationship between expectations and outcomes may be more complex than previously believed.  
  Address Group Health Research Institute, Group Health Cooperative, Seattle, WA 98101, USA. sherman.k@ghc.org  
  Publisher
  Language Number of Treatments 10  
  Treatment Follow-up 52 Weeks Frequency >1/WK Number of Participants 477  
  Time in Treatment 7 Weeks Condition Low Back Pain, Chronic
  Disease Category Back Pain OCSI Score  
  Notes Approved no  
  Call Number Serial 1043  
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