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Self-efficacy improvements seen in patients with knee OA, higher treatment expectations
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Patients with providers that expressed higher expectations about the success of acupuncture treatment showed improved self-efficacy, which was related to pain relief, according to recently published research.
“[O]ur study demonstrates that for knee [osteoarthritis] OA patients undergoing acupuncture treatment in an [randomized controlled trial] RCT setting, provider communication style influences patient self-efficacy, which mediated their pain improvements,” Grace Hsiao-Wei Lo, MD, MSc, from the Baylor College of Medicine, and colleagues wrote in their study. “This study underscores the potential benefits of improved patient self-efficacy that can result from positive messages from providers. This is an inexpensive intervention that can provide an important benefit in a disease where currently few treatment options exist.”
Grace Hsiao-Wei Lo
Lo and colleagues evaluated 485 participants with knee OA randomized to either acupuncture, sham acupuncture or wait list groups and given either a high or a neutral expectation of treatment success, according to the abstract. The acupuncturists conveying high expectations used phrases like, “I’ve had a lot of success with treating these symptoms,” “I expect this treatment to work” and “I’m positive that this treatment will work for you.” Acupuncturists using neutral language used phrases such as, “Different people experience different results while undergoing this treatment,” “This treatment may or may not work for you” and “We are not certain if acupuncture will work for knee pain.” The researchers recorded pain using the WOMAC pain subscale and assessed patient self-efficacy through a modified arthritis self-efficacy questionnaire at 3 months.
The investigators found patients in groups in which acupuncturists conveyed a higher expectation showed greater self-efficacy (beta coefficient = 0.14), while self-efficacy was also significantly associated with WOMAC pain after investigators controlled for acupuncturists’ expectations (beta coefficient = −9.29), according to the abstract.
“Because the indirect effect of a x b was −1.36 for high expectation compared to neutral (bootstrap 95% CI -22.80, -0.15), a statistically significant finding (eg, the 95% CI does not include 0), this result supports the conclusion that higher patient self-efficacy mediates the relationship between provider-communicated expectations of treatment effects and knee pain at 3 months in those with knee OA in this RCT,” Lo and colleagues wrote in their study. – by Jeff Craven
Disclosures: Lo received a mentored award from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Please see the full study for a list of all other authors’ relevant financial disclosures.
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