Complementary therapies in medicine
-
Complement Ther Med · Apr 2008
Self-help advice as a process integral to traditional acupuncture care: implications for trial design.
In the literature on acupuncture research, the active (or specific) component of acupuncture is almost always presented as acupuncture needling alone. However, specific components, by definition, should include all interventions driven by acupuncture theory that are also believed to be causally associated with outcome. In this paper, we explore the delivery of self-help advice as a component of the process of acupuncture care, and discuss the implications for future trial designs. ⋯ Within acupuncture care, self-help advice is not seen as an 'add-on' but rather as an integral and interactive component of a theory-based complex intervention. Studies designed to evaluate the overall effectiveness of traditional acupuncture should accommodate the full range of therapeutic components, strategies and related patient-centred treatment processes. In acupuncture trials, non-needling components, such as self-help advice, when drawn directly from the diagnosis and integral to the process of care, should not be misclassified as incidental, non-specific, or placebo if we are to accurately assess the value of treatment as delivered.