Baseline sample characteristics for the BackInAction pragmatic trial of acupuncture for chronic low back pain in older adults.

Chronic low back pain affects millions of older adults, but we don't have enough research on whether acupuncture works well for people over 65. The BackInAction study is addressing this gap by enrolling 800 older adults with chronic low back pain across four different U.S. healthcare systems. Participants were randomly assigned to receive standard acupuncture, standard acupuncture with additional maintenance sessions, or usual medical care. This report describes who enrolled in the study before treatment began. The average participant was about 74 years old, and most were women (62%) and non-Hispanic white (65%). However, the study successfully enrolled diverse populations across different settings. The federally qualified health center (FQHC), which serves underserved communities, enrolled younger participants who were more racially diverse, had lower incomes, and reported higher levels of back pain-related disability. The fee-for-service system enrolled older participants with similar pain levels to other sites. Importantly, COVID-19 waves during recruitment didn't affect who enrolled at different sites. These findings highlight that people in underserved communities may experience more severe back pain and disability, making it crucial to include diverse healthcare settings in research studies. The actual treatment results haven't been published yet, but this study will provide important information about whether acupuncture helps older adults with chronic low back pain across different populations and healthcare settings. If you're considering acupuncture for back pain, seek a licensed or certified acupuncturist with experience treating older adults.

The BackInAction pragmatic trial enrolled 800 participants aged ≥65 years with chronic low back pain across four U.S. healthcare systems to evaluate acupuncture effectiveness. This baseline characteristics report describes participants randomized to standard acupuncture, acupuncture plus maintenance sessions, or usual care. The sample averaged 73.6 years, was 61.9% female, and 64.6% non-Hispanic white. Significant site differences emerged: the federally qualified health center (FQHC) enrolled younger, more racially diverse, and socioeconomically disadvantaged participants with higher baseline back pain-related dysfunction compared to integrated delivery systems. The fee-for-service system enrolled older participants with dysfunction levels similar to integrated systems. COVID-19 waves did not affect recruitment patterns across sites. Clinical implications include recognition that FQHC populations present with higher social and clinical risk profiles, underscoring the importance of including diverse healthcare settings in pragmatic trials. This study will provide critical evidence on acupuncture effectiveness for geriatric chronic low back pain across varied healthcare delivery models and patient populations.