Trial Information

The Impact of Patient-Provider Interaction on Response to Acupuncture

This study will examine placebo responses in the context of practitioner-patient
interactions at the time of the encounter. Phase 1 of this study identified patient-related
determinants of placebo response, such as beliefs and expectations toward treatment of knee
OA with acupuncture. Phase 2 of the study evaluated an assessment tool to measure these
determinants. Phase 3 of the study is a randomized controlled trial to evaluate whether
placebo effects in patients with knee OA can be enhanced by the acupuncturists'
communicative style, which can affect a patient's cognitive expectancies and beliefs.

Patients will initially be randomized to one of two groups, each with a different model for
practitioner-patient interaction. Acupuncture practitioners will be trained to follow
semi-structured communicative styles, including traditional approaches in Chinese medicine
and techniques previously described in patient-doctor communications studies. Within each
of these groups, patients will be further randomized to receive either acupuncture or sham
acupuncture. Patients will have 6 weeks of biweekly treatment visits. Patients will be
followed for 6 months. Visits will be weekly during the first 6 weeks of the study and
monthly thereafter.

The study will also include a natural cohort group composed of patients on a study waiting
list; these patients will be offered acupuncture 3 months after study entry.