MOCAM

• Research type

  Research Study

• Full title

  Non-specific Mechanisms in Orthodox and CAM management of back pain

• IRAS ID

  160085

• Contact name

  Felicity Bishop

• Contact email

  F.L.Bishop@southampton.ac.uk

• Research summary

  Components other than the active ingredients of treatment can have substantial effects on pain and disability. There are five domains of "non-specific" components: the therapeutic relationship, the healthcare environment, superficial treatment characteristics, patients' beliefs, and practitioners' beliefs. Complementary and alternative medicines like acupuncture have particularly powerful non-specific components. However, existing evidence is based primarily on studies of single components, in single treatments, in isolation from pain theories. This project investigates multiple non-specific components in three treatments and relates them to pain theories.

  We aim to:
  • Identify the most powerful non-specific treatment components.•
  • Compare their effects on patient outcomes across three treatments.
  • Develop a deeper understanding of the pathways through which they generate positive patient outcomes.

  We will recruit a cohort of 1548 adults with back pain attending acupuncturists, physiotherapists, and osteopaths in private and NHS clinics. A quantitative longitudinal questionnaire-based study will use advanced statistical techniques (multi-level modelling) to test hypothesised relationships between five domains of non-specific components, key theoretically-derived mediators (e.g. behaviour change, self-efficacy), and patient outcomes (e.g. disability). Participants will complete questionnaires after their first treatment for a new episode of back pain, 2 weeks later and 3 months later. They will be able to choose whether to complete paper-based or online questionnaires. A randomised sample of 63 consultations (21 per treatment) will be audio-recorded and analysed using the quantitative Roter Interactional Analysis System and inductive qualitative analysis, to identify treatment-enhancing communication practices. Informed consent will be obtained from all participants.

• REC name

  East Midlands - Derby Research Ethics Committee

• REC reference

  14/EM/1113

• Date of REC Opinion

  22 Aug 2014

• REC opinion

  Further Information Favourable Opinion