Pragmatic Research of Acupuncture and Counseling eXtended to Inpatient Services

This study compares clinically-relevant therapeutic options in two high-volume hospitals (one public, one university) to address the core research question of whether non-pharmacologic approaches improve symptom management among diverse inpatients. Study investigators will assess the effectiveness of acupuncture and of pain counseling independently and in combination. Participants will be randomized to two factors each with two levels, yielding four experimental conditions: (1) standard pharmacologic pain management, (2) pharmacologic pain management + acupuncture, (3) pharmacologic pain management + pain counseling, (4) pharmacologic pain management + acupuncture + pain counseling. Patient outcomes will be assessed using a mixed-methods approach, with validated scales for quantitative measures and qualitative interviews to elicit stakeholder perspectives (patients, caregivers, providers). The study will be conducted as a pragmatic clinical trial at two hospitals to address these aims: 1. Determine the effectiveness of adjunctive acupuncture and of pain counseling for improving pain management. 2. Determine the extent that adjunctive acupuncture and pain counseling reduce use of opioid analgesics and side effects. 3. Examine stakeholder perspectives on non-pharmacologic approaches to pain management.