How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?

Background: Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupu...

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Main Authors: Xiaotong Li, Raymond E. Baser, Karolina Bryl, Lindsay Amann, Susan Chimonas, Jun J. Mao
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:Integrative Medicine Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213422024000209
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author Xiaotong Li
Raymond E. Baser
Karolina Bryl
Lindsay Amann
Susan Chimonas
Jun J. Mao
author_facet Xiaotong Li
Raymond E. Baser
Karolina Bryl
Lindsay Amann
Susan Chimonas
Jun J. Mao
author_sort Xiaotong Li
collection DOAJ
description Background: Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupuncture (BFA). Methods: We analyzed data from a randomized clinical trial that compared EA and BFA versus wait list control (WLC) for chronic musculoskeletal pain in cancer survivors. Expectancy was measured by the Acupuncture Expectancy Scale (AES) at baseline. Pain severity was assessed using the Brief Pain Inventory (BPI) at baseline and week 12. For each treatment arm, multivariable regression models were used to evaluate the association between pretreatment expectancy and week 12 pain severity, controlling for baseline pain severity, age, sex, race, and education. Results: Among 360 participants enrolled, the mean age was 62.1 years (SD 12.7), with 251 (69.7 %) women and 88 (24.4 %) non-white survivors. Pretreatment expectancy was similar for all groups at baseline (EA: 13.9 ± 3.6; BFA: 13.2 ± 3.7, WLC:12.8 ± 3.3, p = 0.14). Greater pretreatment expectancy was not significantly associated with greater pain reduction in any group, after adjusting for co-variates (EA: Coef. = -0.05, 95 % CI = -0.14 – 0.04, p = 0.28; BFA: Coef. = -0.07, 95 % CI = -0.16 – 0.02, p = 0.15; WLC: Coef. = -0.09, 95 % CI = -0.25 – 0.06, p = 0.23). Conclusions: Pretreatment expectancy did not predict pain reduction for either EA or BFA in cancer survivors. Our study contributes to the interpretation of analgesic effects of EA or BFA, beyond the notion of a mere 'placebo effect'.
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spelling doaj-art-b01827e3488b4813aa379ed37770c35f2025-08-20T02:54:40ZengElsevierIntegrative Medicine Research2213-42202024-06-0113210104010.1016/j.imr.2024.101040How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?Xiaotong Li0Raymond E. Baser1Karolina Bryl2Lindsay Amann3Susan Chimonas4Jun J. Mao5Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United StatesDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United StatesIntegrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United StatesIntegrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United StatesCenter for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United StatesIntegrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Corresponding author at: Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center 321 East 61st Street, 4th Floor, New York, NY 10065 United States.Background: Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupuncture (BFA). Methods: We analyzed data from a randomized clinical trial that compared EA and BFA versus wait list control (WLC) for chronic musculoskeletal pain in cancer survivors. Expectancy was measured by the Acupuncture Expectancy Scale (AES) at baseline. Pain severity was assessed using the Brief Pain Inventory (BPI) at baseline and week 12. For each treatment arm, multivariable regression models were used to evaluate the association between pretreatment expectancy and week 12 pain severity, controlling for baseline pain severity, age, sex, race, and education. Results: Among 360 participants enrolled, the mean age was 62.1 years (SD 12.7), with 251 (69.7 %) women and 88 (24.4 %) non-white survivors. Pretreatment expectancy was similar for all groups at baseline (EA: 13.9 ± 3.6; BFA: 13.2 ± 3.7, WLC:12.8 ± 3.3, p = 0.14). Greater pretreatment expectancy was not significantly associated with greater pain reduction in any group, after adjusting for co-variates (EA: Coef. = -0.05, 95 % CI = -0.14 – 0.04, p = 0.28; BFA: Coef. = -0.07, 95 % CI = -0.16 – 0.02, p = 0.15; WLC: Coef. = -0.09, 95 % CI = -0.25 – 0.06, p = 0.23). Conclusions: Pretreatment expectancy did not predict pain reduction for either EA or BFA in cancer survivors. Our study contributes to the interpretation of analgesic effects of EA or BFA, beyond the notion of a mere 'placebo effect'.http://www.sciencedirect.com/science/article/pii/S2213422024000209ExpectancyNonspecific effectPainElectroacupunctureBattlefield acupuncture
spellingShingle Xiaotong Li
Raymond E. Baser
Karolina Bryl
Lindsay Amann
Susan Chimonas
Jun J. Mao
How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
Integrative Medicine Research
Expectancy
Nonspecific effect
Pain
Electroacupuncture
Battlefield acupuncture
title How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
title_full How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
title_fullStr How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
title_full_unstemmed How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
title_short How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?
title_sort how does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors
topic Expectancy
Nonspecific effect
Pain
Electroacupuncture
Battlefield acupuncture
url http://www.sciencedirect.com/science/article/pii/S2213422024000209
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