Qi's Clinic, Real-World Effectiveness of an Acupuncture-First Stepped Care Pathway for Pain Management: An Episode-Based Observational Study in Routine Outpatient Clinical Practice Supported by an ES-Enabled Clinical System

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:

• What proportion of completed pain episodes achieve a clinically meaningful improvement, defined as a ≥50% reduction in pain intensity (Numeric Rating Scale or Visual Analog Scale) within an episode treatment window of up to 8 acupuncture visits?
• What are the visit utilization patterns, time to clinically meaningful improvement, and care escalation patterns within an acupuncture-first stepped care pathway in routine outpatient practice?

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:

• Receive acupuncture treatment as part of routine outpatient care
• Undergo routine pain assessments (NRS/VAS) at each clinical visit
• Participate in standard clinical follow-up as determined by usual care practices

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.