Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain

Karen J. Sherman, Daniel C. Cherkin, Laura Ichikawa, Andrew L. Avins, Kristin Delaney, William E. Barlow, Partap S. Khalsa, Richard (Rick) Deyo

Research output: Contribution to journalArticle

62 Citations (Scopus)

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-naïve 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.

Original languageEnglish (US)
Pages (from-to)1471-1477
Number of pages7
JournalSpine
Volume35
Issue number15
DOIs
StatePublished - Jul 1 2010

Fingerprint

Acupuncture
Back Pain
Chronic Pain
Therapeutics
Acupuncture Therapy
Patient Preference
Random Allocation
Low Back Pain
Telephone
Randomized Controlled Trials
Outcome Assessment (Health Care)
Interviews

Keywords

  • Acupuncture
  • Chronic low back pain
  • Patient expectations
  • Patient preferences

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Sherman, K. J., Cherkin, D. C., Ichikawa, L., Avins, A. L., Delaney, K., Barlow, W. E., ... Deyo, R. R. (2010). Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain. Spine, 35(15), 1471-1477. https://doi.org/10.1097/BRS.0b013e3181c2a8d3

Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain. / Sherman, Karen J.; Cherkin, Daniel C.; Ichikawa, Laura; Avins, Andrew L.; Delaney, Kristin; Barlow, William E.; Khalsa, Partap S.; Deyo, Richard (Rick).

In: Spine, Vol. 35, No. 15, 01.07.2010, p. 1471-1477.

Research output: Contribution to journalArticle

Sherman, KJ, Cherkin, DC, Ichikawa, L, Avins, AL, Delaney, K, Barlow, WE, Khalsa, PS & Deyo, RR 2010, 'Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain', Spine, vol. 35, no. 15, pp. 1471-1477. https://doi.org/10.1097/BRS.0b013e3181c2a8d3
Sherman KJ, Cherkin DC, Ichikawa L, Avins AL, Delaney K, Barlow WE et al. Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain. Spine. 2010 Jul 1;35(15):1471-1477. https://doi.org/10.1097/BRS.0b013e3181c2a8d3
Sherman, Karen J. ; Cherkin, Daniel C. ; Ichikawa, Laura ; Avins, Andrew L. ; Delaney, Kristin ; Barlow, William E. ; Khalsa, Partap S. ; Deyo, Richard (Rick). / Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain. In: Spine. 2010 ; Vol. 35, No. 15. pp. 1471-1477.
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