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Trial registered on ANZCTR
Registration number
ACTRN12609000676213
Ethics application status
Approved
Date submitted
30/07/2009
Date registered
7/08/2009
Date last updated
15/10/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of electroacupuncture on opioid consumption by patients with chronic pain
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Scientific title
Effect of electroacupuncture on opioid consumption by patients with chronic musculoskeletal pain: a randomised sham acupuncture controlled trial
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Secondary ID [1]
279927
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NIL
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Universal Trial Number (UTN)
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Trial acronym
EA OM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
chronic musculoskeletal pain
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use of opioid medications
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Condition category
Condition code
Musculoskeletal
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0
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Other muscular and skeletal disorders
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Alternative and Complementary Medicine
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0
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Other alternative and complementary medicine
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Other
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0
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Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Electrical acupuncture will be applied to the arms and legs. During the treatment, electrical current delivered with a battery-operated eletrical stimulator is combined with acupuncture needle techniques to enhance stimulation of the acupuncture points. Each treatment session takes 25 to 30 minutes. The treatment will be given twice a week for four weeks followed by once a week for two weeks then once every two weeks for four weeks. In total, 12 sessions are delivered within 10 weeks.
Participants in this group will also receive pain and medication management (i.e., standard care).
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Intervention code [1]
236696
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Treatment: Devices
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Comparator / control treatment
Conotrol arm 1: Sham electroacupuncture control.
This group will receive similar treatment to that delivered to the real electroacupuncture group. Each session takes 25 to 30 minutes. In total, 12 sessions of treatment are delivered within 10 weeks.
Participants in this group will also receive pain and medication management (i.e., standard care).
Control arm 2: Standard care control (pain and medication management)
This group will receive pain and medication management for 10 weeks without electroacupuncture treatment.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The weekly dosage of opioid medicaitons (OM). This will be calculated based on the data recorded by the pariticipants in their Pain and Medication Diary.
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Assessment method [1]
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Timepoint [1]
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At the end of the treatment period, i.e. 10 weeks following randomisation.
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Secondary outcome [1]
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1) Number of participants who achieve 50% OM reduction
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Assessment method [1]
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Timepoint [1]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [2]
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2) Type, severity and incidence of OM related common adverse events (AEs). Common AEs are somnolence, mental clouding, nausea and constipation. They are assessed with six-point scales (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe, and 5 = extremely severe) to indicate the severity of these events. The scales are included at the end of Pain and Medication Diary that is completed by the participants.
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Assessment method [2]
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Timepoint [2]
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at the end of the treatment period, i.e. 10 weeks following randomisation
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Secondary outcome [3]
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3) Pain intensity measured with Visual Analogue Scales (VASs; 0 = no pain; 10 = worst pain possible) and with the numerical scales included in the Brief Pain Inventory
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Assessment method [3]
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Timepoint [3]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [4]
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4) Consumption of non-opioid medications that are recorded by the participants in their Pain and Medication Diary. To make meaningful comparisons of non-opioid medications use, the dosage of such medications will be calculated according to Medication Quantification Scale Version III (MQS).
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Assessment method [4]
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Timepoint [4]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [5]
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5) Quality of life assessed with SF-36v2 Health Survey
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Assessment method [5]
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Timepoint [5]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [6]
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6) participants' attitude of paina as assessed with Survey of Patients Attitude.
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Assessment method [6]
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Timepoint [6]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [7]
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7) The level of function assessed with the Roland-Morris Disability Questionnaire (RMDQ) and the Brief Pain Inventory;
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Assessment method [7]
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Timepoint [7]
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At the end of the treatment period, i.e. 10 weeks following randomisation; and
at the end of the follow-up period, i.e. three months after the end of the treatment.
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Secondary outcome [8]
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8) The presentation and severity of withdrawal symptoms assessed with Short Opiate Withdrawal Scale.
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Assessment method [8]
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Timepoint [8]
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At the end of the treatment period, i.e. 10 weeks following randomisation
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Secondary outcome [9]
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10) The proportion of neuropathic versus nociceptive pain assessed with the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (S-LANSS)
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Assessment method [9]
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Timepoint [9]
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At the end of the treatment period, i.e. 10 weeks following randomisation
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Secondary outcome [10]
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11) The Perception of EA Treatment Questionnaire will be given to the two electroacupuncture groups to assess the success of blinding
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Assessment method [10]
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Timepoint [10]
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In the 6th and 14th weeks, i.e. two and 10 weeks following randomisation.
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Eligibility
Key inclusion criteria
1) age between 18 and 85 years at entry; 2) confident in conversational and reading English; 3) suffering from chronic musculoskeletal pain (CMP), regardless of the locations of pain; and 4) have taken opioid medication (OM) regularly for more than two months without dose limitation.
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Minimum age
18
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) active abuse of OM as judged by a medical doctor (MD); 2) severely depressed with suicidal tendency as judged by MDs; 3) unstable heart condition, pregnancy or intent to become pregnant, breast feeding women, epilepsy, brain tumor, current cancer, hemophilia or wearing cardiac pacemakers; 4) no general practitioner available for liaison; 5) acupuncture treatment in the last 12 months; or 6) unwilling to reduce OM.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Potential subjects will be recruited from two pain management centres in Melbourne. After a four-week run-in period, subjects who meet all selection criteria will be randomly allocated into one of the three groups, namely real electroacupuncture, sham electroacupuncture or no electroacupuncture with a 2:1:1 ratio. Central randomisation by phone will be used. The acupuncturist is the only person who will know the treatment allocation. All other clinicians and reseachers will be blinded to the treatment allocation.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
An automated telephone randomisation service will be used.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
All subjects will receive pain and medication management from the medical doctors at the clinics.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
30/07/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
316
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
1789
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3162
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Recruitment postcode(s) [2]
1879
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3052
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health & Medical Research Council(NHMRC)
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Address [1]
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GPO Box 1421
Canberra, ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Professor Charlie Xue
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Address
Discipline of Chinese Medicine,
School of Health Sciences,
PO Box 71, Bundoora, Vic 3083
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Doctor Zhen Zheng
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Address [1]
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Discipline of Chinese Medicine,
School of Health Sciences.
PO Box 71, Bundoora, Vic 3083
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Professor Stephen Gibson
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Address [2]
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National Ageing Research Institute,
Poplar Road,
PO Box 2127,
Parkville, Vic 3050
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Country [2]
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Australia
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Secondary sponsor category [3]
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Individual
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Name [3]
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Professor Robert Helme
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Address [3]
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Department of Medicine,
Royal Melbourne Hospital,
Parkville, Vic 3050
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Country [3]
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Australia
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Secondary sponsor category [4]
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Individual
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Name [4]
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Doctor Carolyn Arnold
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Address [4]
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Caulfield Pain Management and Research Centre,
Caulfield Hospital,
260 Kooyong Rd, Caulfield, Vic 3162
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Country [4]
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Australia
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Secondary sponsor category [5]
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Individual
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Name [5]
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Doctor Malcolm Hogg
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Address [5]
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Pain Services,
Royal Melbourne Hospital,
Poplar Road, Royal Park Campus,
Parkville, Vic 3050
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Country [5]
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Australia
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Other collaborator category [1]
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Hospital
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Name [1]
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Caulfield Pain Management and Research Centre
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Address [1]
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Caulfield Hospital,
260 Kooyong Rd, Caulfield, Vic 3162
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Country [1]
703
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Australia
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Other collaborator category [2]
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Hospital
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Name [2]
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Pain Services
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Address [2]
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Royal Melbourne Hospital,
Poplar Road, Royal Park Campus,
Parkville, Vic 3050
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Alfred Research & Ethics Unit
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Ethics committee address [1]
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The Alfred Health, 55 Commercial Road, Melbourne, Vic 3004
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
239188
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16/03/2009
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Approval date [1]
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02/06/2009
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Ethics approval number [1]
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HREC 80/09
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Ethics committee name [2]
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [2]
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Office for Research, Level 6 East, Main Building, Grattan Street, The Royal Melbourne Hospital, Parkville, Vic 3050
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
239189
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25/02/2009
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Approval date [2]
239189
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17/06/2009
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Ethics approval number [2]
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2009.033
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Ethics committee name [3]
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Royal Melbourne Institute of Technology (RMIT) University Human Research Ethics Committee
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Ethics committee address [3]
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Research & Innovation, RMIT, GPO Box 2476V, Melbourne, Vic 3001
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
239369
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16/02/2009
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Approval date [3]
239369
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20/04/2009
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Ethics approval number [3]
239369
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06/09/
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Summary
Brief summary
Our primary hypothesis is that electroacupuncture (EA), as a supplementary therapy to stardard care, that is pain medication management (PMM), can effectively reduce the use of opioid medications (OMs) in the management of chronic musculoskeletal pain (CMP). About the problem: Seventeen (17%) to 20% of Australians suffer from chronic pain, with the majority of them having CMP. Moderate to severe CMP has been increasingly managed with OM. In Australia, in 1999, 13% of chronic pain patients were using some type of OMs. Since then, the consumption of some OMs has increased by 5 to 40 times. About the use of OMs: Although short-term benefit of OMs for CMP has been demonstrated, its long-term use is a problem. Studies have shown that chronic pain patients who are on long-term OMs, experience more severe pain, poorer quality of life, and are more likely to have adopted passive pain coping strategies. Thus, effective measures that reduce the OM use and OM related adverse effects are urgently needed. About EA and its benefit: Animal and human studies have shown that EA not only increases the release of endogenous opioids, but also help our body to use opioid medications more efficiently. Our pilot study (Zheng et al, EJP, 2008) demonstrated that real EA, when combined with PMM, reduced the OM consumption more effectively than sham EA did. The proposed research will employ an adequate sample size with an additional no-EA group to determine the benefit and safety of EA for the reduction of OM consumption by subjects with CMP.
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Trial website
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Trial related presentations / publications
Zheng, Z., Guo, R. X., Helme, R. D., Muir, A., Da Costa, C. and Xue, C. L. (2008) The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: A randomized controlled clinical trial. European Journal of Pain 12(5):671-6.
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Prof Charlie Xue
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Address
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Discipline of Chinese Medicine,
School of Health Sciences,
PO Box 71, Bundoora,
Vic 3083
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Country
12934
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Australia
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Phone
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+61 3 9925 7745
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Fax
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+61 3 9925 7178
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Email
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[email protected]
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Contact person for scientific queries
Name
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Doctor Zhen Zheng
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Address
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Discipline of Chinese Medicine,
School of Health Sciences,
PO Box 71, Bundoora,
Vic 3083
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Country
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Australia
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Phone
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+61 3 9925 7167
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Fax
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+61 3 9925 7178
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effects of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: A multicenter randomized controlled trial.
2019
https://dx.doi.org/10.1093/pm/pny113
N.B. These documents automatically identified may not have been verified by the study sponsor.
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