Acupuncture versus medication for pain management: a cross-sectional study of breast cancer survivors

Original paper http://aim.bmj.com/content/36/2/80.long Ting Bao1, Susan Q Li1, Josh L Dearing1, Lauren A Piulson1, Christina M Seluzicki1, Robert Sidlow2, Jun J Mao1 Author affiliations Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, USA Division of Survivorship and Supportive Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA Correspondence to Dr Ting Bao, Integrative Medicine and Breast Medicine Service, Memorial Sloan Kettering Cancer Center, NY 10021, USA; baot@mskcc.org Abstract Aim of the study Breast cancer survivors who take aromatase inhibitors (AI) often suffer from chronic pain. Emerging evidence supports the use of acupuncture as an effective pain management strategy for this condition, but its acceptability among cancer survivors is unknown. We evaluated breast cancer survivors’ preferences for acupuncture as compared with medication use and identified factors predictive of this preference. Methods We conducted a cross-sectional study among breast cancer survivors who were currently, or had been, taking an AI. The primary outcome was degree of preference for acupuncture as compared with medication for pain management. We conducted multivariate logistic regression analyses to evaluate the effects of socioeconomic status (SES) factors and health beliefs on treatment preference. Results Among 592 participants, 160 (27.0%) preferred acupuncture, 153 (25.8%) preferred medication and 279 (47.1%) had no clear preference. In a multivariate analysis that only included SES, higher education and white race were significantly associated with greater preference for acupuncture. When health beliefs were added, SES effects were attenuated, while greater expectation of acupuncture’s effect, lower perceived barriers to its use, higher social norm (endorsement from family members and healthcare professionals) related to acupuncture and higher holistic health beliefs were associated with greater preference for acupuncture. Conclusion We found similar rates of preference for acupuncture versus medication among breast cancer survivors for pain management. Specific attitudes and beliefs predicted such preferences, highlighting the importance of a patient-centred approach to align patient beliefs and preferences with therapeutic options for more effective pain management. Trial registration number NCT01013337; Results. http://dx.doi.org/10.1136/acupmed-2017-011435 View Full Text Footnotes Contributors TB analysed the data, and drafted and revised the paper. SQL cleaned and analysed the data, and revised the paper. JLD and CMS conducted the study, collected the data and revised the paper. LAP and RS analysed the data and revised the draft paper. JJM designed the trial, analysed the data and revised the paper. Funding This study was funded in part by a National Cancer Institute R01CA158243 (JJM) and R21CA173263 (TB), a Memorial Sloan Kettering Cancer Center P30 grant (P30-CA008748), and the Byrne Fund at Memorial Sloan Kettering Cancer Center. The funding sources had no involvement in study design; collection, analysis and interpretation of data; writing of the report; or decision to submit the article for publication. Competing interests None declared. Ethics approval The Institutional Review Board of the University of Pennsylvania approved the study protocol. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Individual participant data that underlie the results reported in this article, after de-identification, and study protocol can be shared with researchers who provide a methodologically sound proposal beginning 3 months and ending 5 years after article publication. Proposals should be directed to baot@mskcc.org. To gain access, data requestors will need to sign a data access agreement. If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways. Request permissions Copyright information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.