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Overlap and differences between patient and provider expectations for treatment outcomes: the case of acupuncture


Barth, Jürgen; Schafroth, Larissa; Witt, Claudia M (2016). Overlap and differences between patient and provider expectations for treatment outcomes: the case of acupuncture. Journal of Pain, 17(6):685-693.

Abstract

Our study aimed to identify patient-provider clusters with different patterns of expectations for treatment outcomes. All patients (n = 885) received acupuncture treatment from physicians for their migraine, headache, osteoarthritis, or chronic low back pain. We identified 6 robust patient-provider expectation clusters (PPECs; interclassification reliability >.89) showing differences between patients and providers in their expected treatment responses (eg, unrealistic optimists, optimistic doubters). For example, the optimistic doubters had high expectations for their treatment outcomes but were skeptical of the benefits of acupuncture in general. The providers expected good improvements for these patients. These 6 PPECs differed in their clinical characteristics and in the associated treatment responses. For example, unrealistic optimists showed the weakest treatment benefits after 6 months; other PPECs and clinical patterns are also presented in the report. Our study suggests that comparing the expectations of patients and providers is a valuable approach to identify groups of patients with greater responsiveness and those with limited treatment benefits. PERSPECTIVE: Patients and providers of acupuncture might vary in their expectation of the treatment effect and in clinical practice the overlap of expectations of patients and providers should be considered as important in initial consultations.

Abstract

Our study aimed to identify patient-provider clusters with different patterns of expectations for treatment outcomes. All patients (n = 885) received acupuncture treatment from physicians for their migraine, headache, osteoarthritis, or chronic low back pain. We identified 6 robust patient-provider expectation clusters (PPECs; interclassification reliability >.89) showing differences between patients and providers in their expected treatment responses (eg, unrealistic optimists, optimistic doubters). For example, the optimistic doubters had high expectations for their treatment outcomes but were skeptical of the benefits of acupuncture in general. The providers expected good improvements for these patients. These 6 PPECs differed in their clinical characteristics and in the associated treatment responses. For example, unrealistic optimists showed the weakest treatment benefits after 6 months; other PPECs and clinical patterns are also presented in the report. Our study suggests that comparing the expectations of patients and providers is a valuable approach to identify groups of patients with greater responsiveness and those with limited treatment benefits. PERSPECTIVE: Patients and providers of acupuncture might vary in their expectation of the treatment effect and in clinical practice the overlap of expectations of patients and providers should be considered as important in initial consultations.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Complementary Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:June 2016
Deposited On:06 Dec 2016 16:29
Last Modified:02 Feb 2018 10:50
Publisher:Elsevier
ISSN:1526-5900
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.jpain.2016.01.477
PubMed ID:26921463

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