title: The combined effect of relaxation response and acupuncture on quality of life in patients with HIV: a pilot study.
abstract: OBJECTIVE
  Treatment advances have transformed human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) into a chronic manageable disease; quality of life (QoL) has become an important health outcome. Some studies have shown the individual effects of acupuncture and the relaxation response (RR) in improving QoL of patients with HIV/AIDS. In light of the presumed shared features of acupuncture and the RR, we conducted a pilot study to examine the effects of adding the RR to usual acupuncture treatment on improving the QoL of HIV/AIDS patients.
  
  
  METHODS
  Two-arm double-blind randomized controlled trial. SETTINGS/LOCATION AND SUBJECTS: We enrolled 119 patients with HIV/AIDS (mean age 46 years, 85% male) who had at least 1 of the highly prevalent HIV-related symptoms and who were receiving acupuncture treatment in an acupuncture clinic in Boston, MA.
  
  
  METHODS
  We randomized patients into intervention (N = 58) and control (N = 61) groups. All participants received individualized acupuncture treatments prescribed by their acupuncturists. While receiving acupuncture treatment, the intervention group wore earphones to listen to tapes with instructions to elicit the RR followed by soft music that was routinely played in the clinic; the control group listened only to soft music.
  
  
  METHODS
  Three (3) QoL scales: the Medical Outcomes Study HIV health survey, the Functional Assessment of HIV Infection, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, measured at baseline, 4-week, 8-week, and 12-week follow-ups.
  
  
  RESULTS
  At the 12-week follow-up, the intervention group showed significant improvements in emotional (p = 0.0002), spiritual/peace (p = 0.02), physical (p = 0.003) and mental health (p = 0.0003) QoL from baseline. Results of mixed effects regression models indicated linear trends of improvement over time in these dimensions of QoL for the intervention group (p < 0.02). In the control group, the only significant improvement was observed in the emotional QoL (p < 0.01). The intervention group showed trends of greater improvements than the control group (p = 0.07 for 12-week physical health QoL).
  
  
  CONCLUSIONS
  Data from this pilot trial suggested that adding the RR to acupuncture may enhance improvement in QoL of patients with HIV/AIDS. Further investigation on this putative synergistic effect is warranted.
authors.affiliation: Department of Health Policy and Management, Boston University School of Public Health, Boston, MA 02130, USA. bhchang@bu.edu
authors.forename: Bei-Hung
authors.initials: BH
authors.lastname: Chang
authors.forename: Ulrike
authors.initials: U
authors.lastname: Boehmer
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sommers
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology / Q000534:rehabilitation*; D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012063:Relaxation; D029181:Spirituality; D011795:Surveys and Questionnaires; D016896:Treatment Outcome