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The goal of this observational study is to evaluate the real-world effectiveness of an acupuncture-first stepped care pathway for pain management in adults aged 18 years and older receiving routine outpatient clinical care for non-cancer-related pain conditions. The primary purpose is to describe episode-based clinical outcomes and care utilization patterns as they occur in standard practice.
The main questions it aims to answer are:
There is no comparison group. This study does not introduce or test a new intervention. All care is delivered as part of standard clinical practice.
Participants will:
No additional research-specific visits, procedures, questionnaires, or interventions are introduced. Data analyzed in this study are derived from routine clinical documentation systems and are de-identified prior to analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acupuncture-First Stepped Care Cohort |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Acupuncture-First Stepped Care Pathway (Routine Clinical Care) | Procedure | This study does not assign or manipulate any intervention. Participants receive routine outpatient acupuncture care delivered within an existing acupuncture-first stepped care pathway. The pathway represents standard clinical practice and includes individualized acupuncture treatment decisions made by the treating practitioner. Treatment frequency, duration (up to 8 visits per episode), and potential care escalation are determined solely by routine clinical judgment and patient response. The study does not introduce additional procedures, randomization, comparison groups, or protocol-driven treatment modifications. Data are analyzed observationally from routine clinical documentation. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Pain Episodes Achieving Clinically Meaningful Improvement | Clinically meaningful improvement is defined as a ≥50% reduction in pain intensity from baseline, measured using the Numeric Rating Scale (NRS) or Visual Analog Scale (VAS). The outcome is assessed at the final observed visit within the episode treatment window (up to 8 acupuncture visits) or at episode closure, whichever occurs first. | From baseline (initial visit) through episode closure, up to 12 weeks (maximum of 8 visits) |
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Inclusion Criteria:
Exclusion Criteria:
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The initial analytic cohort will include approximately 300 pain episodes, anticipated to be derived from 250-350 unique adult patients, recognizing that some patients may contribute more than one episode over time. Pain episodes may originate from either clinical site and are analyzed together under the same episode-based framework.
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