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

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

Background: Acupuncture 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.

Methods: In 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.

Results:Three 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.

Conclusions: The 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.

1472-6882
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625

Bishop, Felicity L., Yardley, Lucy, Cooper, Cyrus, Little, Paul and Lewith, George (2017) Predicting adherence to acupuncture appointments for low back pain: a prospective observational study. BMC Complementary and Alternative Medicine, 17 (5). (doi:10.1186/s12906-016-1499-9).

Record type: Article

Abstract

Background: Acupuncture 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.

Methods: In 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.

Results:Three 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.

Conclusions: The 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.

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More information

Accepted/In Press date: 6 December 2016
e-pub ahead of print date: 3 January 2017
Published date: 3 January 2017
Organisations: Primary Care & Population Sciences, Human Wellbeing, Medical Research Council

Identifiers

Local EPrints ID: 407352
URI: https://eprints.soton.ac.uk/id/eprint/407352
ISSN: 1472-6882
PURE UUID: c33a0806-d0ff-41ed-b52c-fb7568ed932f
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 04 Apr 2017 01:05
Last modified: 14 Mar 2019 01:50

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