Differences in psychosocial context between RCTs and usual practice could reduce the impact of acupuncture in RCT settings and may lead to under-reporting of benefit by patients in trials, according to a UK study. Researchers analysed qualitative interviews with 54 patients. Half were drawn from a study of western and traditional acupuncture in usual practice for a range of painful conditions, while the other half were drawn from an RCT of western acupuncture for osteoarthritis. In the RCT, patients experienced considerable uncertainties about their treatment and its effectiveness, and were particularly concerned about whether they were receiving real or fake acupuncture. Since the psychosocial context of treatment is known to influence patient outcomes in chronic illness, this is an important finding. The authors suggests that new trial designs should that ensure participants’ experiences in RCTs are similar to usual practice to minimise differences in psychosocial context and help attenuate potential confounding effects. (How the psychosocial context of clinical trials differs from usual care: a qualitative study of acupuncture patients. BMC Med Res Methodol. 2011 May 25;11:79).
Categories: Basic acupuncture research