Effect of expectation on short- and long-term treatment response to Acupuncture in migraine patients

Introduction: There are relatively few studies addressing the relationship between the patient's expectation and the short and long-term response to treatment with acupuncture. The aim of this study was to assess the association between pre- and post-treatment expectation of acupuncture and post-treatment and post-follow-up patient outcomes. Methods: This was an open-label, randomized controlled clinical trial conducted at the Czech-Chinese Centre for Traditional Chinese Medicine at the University Hospital Hradec Kralove between October 2015 and April 2017. Non-specific factors were examined in the intervention arm using regression analysis. Results: Post-treatment positive expectation concerning the success of the treatment, as well as the affective status of the patient, is one of the most significant nonspecific factors contributing to an increased post-treatment effectiveness of acupuncture; however, this positive expectation decreased with time. On the other hand, the post-follow-up effect of acupuncture was significantly improved by the patients' positive perception of the TCM practitioner. Conclusions: Correct calibration of a patient's expectation, good mental status, and patients' perceptions of an acupuncturist's skills reduced the number of migraine days in patients treated with acupuncture. Understanding non-specific treatment effects can potentially help clinicians to integrate them in to practice and thus optimise treatment effectiveness. Future research is needed to clarify whether interventions targeting modifiable nonspecific factors prior to and during acupuncture treatment can result in better patient outcomes and future cost-savings.