# BackInAction Administrative Supplement

> **NIH NIH UH3** · KAISER FOUNDATION RESEARCH INSTITUTE · 2022 · $592,093

## Abstract

SUMMARY
A critical gap exists in the evidence reading the safety and effectiveness of treatments for older adults with
chronic low back pain (cLBP). Acupuncture has been found to be effective in treating cLBP in younger adults.
Yet trials have rarely included older adults, who have more comorbidities and may respond differently than
typical trial participants. We have designed a pragmatic randomized trial to address this gap. After a planning
year to refine strategies to identify and recruit patients, finalize acupuncture protocols, and ensure data
infrastructure and quality, we will conduct a three-arm trial of 789 adults ≥65 years of age with cLBP to
evaluate acupuncture versus usual care. We will compare a standard 3-month course of acupuncture with an
enhanced course of acupuncture (3-month standard course, plus 3-month maintenance course) to usual
medical care for cLBP. The primary outcomes of this large trial will be back-related function at 6-months.
These and other biopsychosocial measures will be collected at 3-, 6-, and 12-months post randomization. We
predict that back-related function in older adults with cLBP will be most improved among participants in the
enhanced acupuncture arm, followed by the standard acupuncture arm, and least improved among those
receiving only usual care. Medicare is also interested in data on the value of acupuncture for older adults to
inform coverage decisions and efficient implementation. As such, to supplement knowledge gained from the
effectiveness trial, we will conduct a cost-effectiveness analysis of both forms of acupuncture compared to
usual care as well as comprehensive qualitative evaluations to understand, describe and explain barriers and
facilitators to adoption, implementation, and sustainability of acupuncture treatment for older adults. Our large
sample will be recruited from 4 diverse health plans to represent the ethnic and racial composition of Medicare
enrollees as well as the most common ways acupuncture is incorporated in insurance-based care for chronic
pain. If successful, this pragmatic RCT will offer clear guidance about the value of acupuncture for improving
functional status and reducing pain intensity and pain interference for older adults with cLBP. This evidence will
provide essential information for Medicare regarding coverage decisions and for individual physicians and
patients deciding on a course of treatment.

## Key facts

- **NIH application ID:** 10627304
- **Project number:** 3UH3AT010739-04S1
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Andrea Jean Cook
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $592,093
- **Award type:** 3
- **Project period:** 2019-09-28 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10627304

## Citation

> US National Institutes of Health, RePORTER application 10627304, BackInAction Administrative Supplement (3UH3AT010739-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10627304. Licensed CC0.

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