Patient-Provider Interaction & Response to Acupuncture
Principal Investigator: M E Suarez-Almazor
Abstract: The association of positive patient expectations with placebo responses is well recognized. However, the potential role of health care providers' behavior in modeling these expectations has not been adequately established, The overall goal of this proposal is to describe and quantify placebo effects in a trial of acupuncture for osteoarthritis (OA) of the knee. No previous studies have scientifically evaluated the effects of communicative style in providers of alternative and complementary medicine, and tile placebo response that may result. This proposal will examine placebo responses in the context of practitioner-patient interactions at the time of the acupuncture treatment. The study will have three phases: Phase 1 will include a qualitative component to determine potential patient-related determinants of placebo response, such as beliefs and expectations towards treatment of knee OA with acupuncture, in phase 2 we will develop and test an instrument to measure evaluate outcome and self efficacy expectations. Phase 3 will be a nested RCT to evaluate practitioner-patient interactions and placebo responses. The experimental design will include two stages or randomization. Patients will initially be randomized to one of two different structures of practitioner-patient interaction. Acupuncture practitioners will be trained to behave following semi-structured communicative styles, including traditional approaches in Chinese Medicine, and techniques previously described in patient-doctor communication studies. Within each of these groups patients will be further randomized to receive acupuncture or sham acupuncture. In addition there will be a natural control group (waiting list group), in which patients will be offered acupuncture three months after study entry.
Funding Period: 2002-09-26 - 2008-06-30
more information: NIH RePORT
- Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectivenessRichard L Street
Department of Communication, Texas A and M University, College Station, TX 77843 4234, USA
Patient Educ Couns 89:245-51. 2012....
- Early responses predict better outcomes in patients with newly diagnosed chronic myeloid leukemia: results with four tyrosine kinase inhibitor modalitiesPreetesh Jain
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Blood 121:4867-74. 2013..Early responses are predictive for EFS and failure-free survival and to a lesser extent OS, regardless of the treatment modality, although therapies other than standard-dose imatinib result in higher rates of deep early responses...
- A randomized controlled trial of acupuncture for osteoarthritis of the knee: effects of patient-provider communicationMaria E Suarez-Almazor
University of Texas MD Anderson Cancer Center, Houston, TX, USA
Arthritis Care Res (Hoboken) 62:1229-36. 2010..We conducted a 3-month randomized clinical trial in patients with knee osteoarthritis to compare the efficacy of TCA with sham acupuncture and to examine the effects of acupuncturists' communication styles...
- A combined-method psychometric analysis recommended modification of the multidimensional health locus of control scalesP A Kelly
Michael E DeBakey VA Medical Center, and Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
J Clin Epidemiol 60:440-7. 2007..We evaluated the scales over the largest-ever disease-specific sample of subjects using a combined-method psychometric approach...