Abstract
To test whether a newly developed person-, theory- and evidence-based website about acupuncture helps patients make informed decisions about whether or not to use acupuncture for back pain. A randomised online study compared a newly developed 'enhanced website' to a 'standard website'. The enhanced website provided evidence-based information in a person-based manner and targeted psychological constructs. The standard website was based on a widely used patient information leaflet. In total, 350 adults with recent self-reported back pain were recruited from general practices in South West England. The two primary outcomes were knowledge change and making an informed choice about using acupuncture. Secondary outcomes were beliefs about and willingness to have acupuncture. Participants who viewed the enhanced acupuncture website had a significantly greater increase in knowledge about acupuncture (M = 1.1, standard deviation (SD) = 1.7) than participants who viewed the standard website (M = 0.2, SD = 1.1; F(1, 315) = 37.93, p < 0.001, η2 = .107). Participants who viewed the enhanced acupuncture website were also 3.3 times more likely to make an informed choice about using acupuncture than those who viewed the standard website (χ2(1) = 23.46, p < 0.001). There were no significant effects on treatment beliefs or willingness to have acupuncture. The enhanced website improved patients' knowledge and ability to make an informed choice about acupuncture, but did not optimise treatment beliefs or change willingness to have acupuncture. The enhanced website could be used to support informed decision-making among primary care patients and members of the general public considering using acupuncture for back pain.
Highlights
In the United Kingdom alone, approximately 4 million acupuncture treatments are provided annually by over 10,000 registered acupuncturists practicing a range of acupuncture styles.[1]
There was a significant association between website and informed choice about acupuncture (χ2(1) = 23.46, p < 0.001), with 32.9% (52/158) of people who viewed the enhanced website making an informed choice about acupuncture compared to 10.1% (15/149) of people who viewed the standard website
Participants who viewed the enhanced website were 3.3 times more likely than those who viewed the standard website to make an informed choice about acupuncture
Summary
In the United Kingdom alone, approximately 4 million acupuncture treatments are provided annually by over 10,000 registered acupuncturists practicing a range of acupuncture styles.[1] Back pain is highly prevalent and burdensome for patients and societies,[2,3] the beneficial effects of acupuncture for back pain have been established,[4] and patients commonly seek acupuncture for back pain.[1,5] While the balance of evidence suggests acupuncture is more beneficial than usual care, it may not be superior to placebo or sham acupuncture.[6] This leads to differing interpretations of the evidence base by policy-makers and in clinical guidelines.[6,7,8,9] For example, the UK National Institute for Health and Care Excellence recently switched from recommending to not recommending acupuncture for back pain,[6,9] but their interpretation of the evidence has been criticised for prioritising problematic comparisons with sham acupuncture (which probably has active components) over more clinically meaningful comparisons with usual care.[10] This situation can be confusing for patients and suggests a need for educational resources to support patients making informed choices about acupuncture
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Schedule a callMore From: Acupuncture in medicine : journal of the British Medical Acupuncture Society
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