Predicting adherence to acupuncture appointments for low back pain: a prospective observational study

BMC Complementary and Alternative Medicine

Research Article

Cyrus Cooper¹  George Lewith²  Paul Little²  Felicity L. Bishop³  Lucy Yardley³ 

[1] MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, UK;Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, SO16 5ST, Southampton, UK;Psychology, Faculty of Social and Human Sciences, University of Southampton, Building 44 Highfield Campus, SO17 1BJ, Southampton, UK;

关键词: Acupuncture;    Adherence;    Back pain;    Health knowledge, Attitudes, Practice;    Illness perceptions;    Treatment beliefs;   

DOI  :  10.1186/s12906-016-1499-9

 received in 2016-04-02, accepted in 2016-12-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAcupuncture is a popular form of complementary and alternative medicine (CAM), but it is not clear why patients do (or do not) follow acupuncturists’ treatment recommendations. This study aimed to investigate theoretically-derived predictors of adherence to acupuncture.MethodsIn a prospective study, adults receiving acupuncture for low back pain completed validated questionnaires at baseline, 2 weeks, 3 months, and 6 months. Patients and acupuncturists reported attendance. Logistic regression tested whether illness perceptions, treatment beliefs, and treatment appraisals measured at 2 weeks predicted attendance at all recommended acupuncture appointments.ResultsThree hundred twenty-four people participated (aged 18–89 years, M = 55.9, SD = 14.4; 70% female). 165 (51%) attended all recommended acupuncture appointments. Adherence was predicted by appraising acupuncture as credible, appraising the acupuncturist positively, appraising practicalities of treatment positively, and holding pro-acupuncture treatment beliefs. A multivariable logistic regression model including demographic, clinical, and psychological predictors, fit the data well (χ2 (21) = 52.723, p < .001), explained 20% of the variance, and correctly classified 65.4% of participants as adherent/non-adherent.ConclusionsThe results partially support the dynamic extended common-sense model for CAM use. As hypothesised, attending all recommended acupuncture appointments was predicted by illness perceptions, treatment beliefs, and treatment appraisals. However, experiencing early changes in symptoms did not predict attendance. Acupuncturists could make small changes to consultations and service organisation to encourage attendance at recommended appointments and thus potentially improve patient outcomes.

【 授权许可】

CC BY   
© The Author(s). 2017