The relationship between patient and practitioner expectations and preferences and clinical outcomes
We investigated the relationship between patient and therapist preferences and expectations and clinical outcomes in a trial of exercise and acupuncture for clinical knee osteoarthritis. 352 Patients were randomised to advice and exercise or advice and exercise plus true or non-penetrating acupuncture. Before randomisation, patients recorded their general outcome expectations, treatment-specific preferences and expectations. Clinical outcome was (a) change scores on the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and (b) treatment response according to the OMERACT-OARSI criteria. Physiotherapists recorded their treatment expectations and preferences for each patient following an assessment prior to randomisation. We investigated the relationship between (a) patient, (b) therapist and (c) matched patient-therapist preferences and expectations on clinical outcomes using univariate and multivariate analyses. There was no significant relationship between patients' treatment preferences and clinical outcomes at 6 or 12months nor between patients' expectations and pain (WOMAC) at 6 or 12months. Using our secondary outcome (OMERART-OARSI), those who received the treatment for which they had high expectations of benefit were almost twice as likely to be classified as a treatment responder at 6months (odds ratio (OR) 1.7 (95% Confidence Interval 1.06, 2.79)) and 12months (OR) 1.9 (1.13, 3.13). Therapists' preferences and expectations for individual patients did not add further explanation of outcomes. There was no evidence of a relationship between patients' treatment preferences or expectations and pain reduction. We found weak evidence, from secondary outcomes, that patients' expectations, both general and treatment-specific, are related to clinical outcome from exercise and acupuncture.
Eur J Pain. 2009 Aug 6. Foster NE, Thomas E, Hill JC, Hay EM. Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom.
Posted: 08/04/2010
This article provided by The International Hypnosis Research Institute.
Enter your email address to subscribe to the IHRI Newsletter.
Reading SpeedDo you wish you could read faster? Hypnosis can help you double or even triple your speed as it works with the part of the mind that is not limited to 5-7 bits of information like your conscious mind.
|
Modeling ExcellenceHypnosis provides some of the best tools for achieving personal transformation.Achieving a level of mastery in any aspect of your life requires re-training your brain and body. Begin creating the mind that is capable of taking you to new heights!
|
Clear & Healty SkinHypnosis is very effective in healing and reducing acne!In this hypnosis session I’ll give your body suggestions that will work at the deep inner mind level so that you’ll naturally want to nurture your skin.You’ll be confident in public!
|
