title: Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial.
abstract: BACKGROUND
  Chronic musculoskeletal pain is common and has been increasingly managed by opioid medications, of which the long-term efficacy is unknown. Furthermore, there is evidence that long-term use of opioids is associated with reduced pain control, declining physical function and quality of life, and could hinder the goals of integrated pain management. Electroacupuncture (EA) has been shown to be effective in reducing postoperative opioid consumption. Limited evidence suggests that acupuncture could assist patients with chronic pain to reduce their requirements for opioids.The proposed research aims to assess if EA is an effective adjunct therapy to standard pain and medication management in reducing opioids use by patients with chronic musculoskeletal pain.
  
  
  METHODS
  In this multicentre, randomised, sham-acupuncture controlled, three-arm clinical trial, 316 patients regularly taking opioids for pain control and meeting the defined selection criteria will be recruited from pain management centres and clinics of primary care providers in Victoria, Australia. After a four-week run-in period, the participants are randomly assigned to one of three treatment groups to receive EA, sham EA or no-EA with a ratio of 2:1:1. All participants receive routine pain medication management delivered and supervised by the trial medical doctors. Twelve sessions of semi-structured EA or sham EA treatment are delivered over 10 weeks. Upon completion of the acupuncture treatment period, there is a 12-week follow-up. In total, participants are involved in the trial for 26 weeks. Outcome measures of opioid and non-opioid medication consumption, pain scores and opioid-related adverse events are documented throughout the study. Quality of life, depression, function, and attitude to pain medications are also assessed.
  
  
  CONCLUSIONS
  This randomised controlled trial will determine whether EA is of significant clinical value in assisting the management of debilitating chronic pain by reducing opioids consumption and their associated adverse events, as well as improving the quality of life for those with chronic pain. Such an outcome will provide the rationale for including EA into multidisciplinary programmes for effective management of chronic musculoskeletal pain.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trial Registry (ACTRN12609000676213)http://www.anzctr.org.au/trial_view.aspx?ID=308008.
authors.affiliation: Traditional and Complementary Medicine Research Program, Health Innovations Research Institute (HIRi), School of Health Sciences, RMIT University, Bundoora, VIC, Australia.
authors.forename: Charlie C L
authors.initials: CC
authors.lastname: Xue
authors.forename: Robert D
authors.initials: RD
authors.lastname: Helme
authors.forename: Stephen
authors.initials: S
authors.lastname: Gibson
authors.forename: Malcolm
authors.initials: M
authors.lastname: Hogg
authors.forename: Carolyn
authors.initials: C
authors.lastname: Arnold
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Somogyi
authors.forename: Cliff
authors.initials: C
authors.lastname: Da Costa
authors.forename: Yanyi
authors.initials: Y
authors.lastname: Wang
authors.forename: Shao-chen
authors.initials: SC
authors.lastname: Lu
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zheng
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology; D015671:Electroacupuncture; D006801:Humans; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D018710:Pain Clinics; D010147:Pain Measurement; D011788:Quality of Life; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria
chemical_list: D000701:Analgesics, Opioid