Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain.
Treatment expectations and preferences as predictors of outcome of acupuncture for chronic back pain.
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DOI：
10.1097/brs.0b013e3181c2a8d3
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发表时间：
2010-07-01
期刊：
影响因子：
3
通讯作者：
Deyo RA
中科院分区：
文献类型：
--
作者：
Sherman KJ;Cherkin DC;Ichikawa L;Avins AL;Delaney K;Barlow WE;Khalsa PS;Deyo RA
研究设计：对随机临床试验中接受针灸治疗的参与者的数据进行预先计划的二次分析。目的：确定患者对针灸的期望和偏好是否能预测慢性背痛患者的短期和长期治疗结果。背景资料摘要：尽管越来越多的证据表明患者的期望和治疗偏好可能预测治疗结果，一些研究已经检查了这种关系acupuncture.Methods.477针灸初治参与者与慢性腰痛谁被随机分配到1 3针灸或模拟针灸治疗是本分析的重点。在7周期间提供10次治疗，参与者对治疗分配设盲。在随机化之前，参与者提供了关于治疗成功的期望，印象以及关于针灸和治疗偏好的知识。关注的结局为功能状态（罗兰评分）和症状困扰在8周和52周后随机化，通过电话采访者获得的治疗assignment.Results.person与高预处理期望的成功针灸更有可能报告更大的一般期望改善，偏好针灸，听说过针灸是一种非常有效的治疗方法，对针灸有非常或中等程度的积极印象。然而，这些变量都不是8周或52周时背部相关症状或功能改善的显著预测因素。在1次治疗后，参与者对治疗成功的修正预期仅与治疗结束时的背部症状相关。经过5次治疗后，修订的成功预期是预测的症状和功能在8和52 weeks.Conclusion.Pretreatment的期望和偏好针灸没有发现预测治疗结果的慢性背痛患者。这些结果不同于以往评估针灸治疗慢性背痛的研究。这些不一致的结果表明，期望和结果之间的关系可能比以前认为的更复杂。
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.