Patients seeking care from acupuncture practitioners in the UK: A national survey

Summary

Objective

The primary aim was to describe the characteristics of acupuncture patients and in particular the main problem or symptom for which they were seeking treatment. Our secondary aim was to compare the profiles of acupuncture patients with those of a patient survey undertaken in 1988.

Methods

We used the data from a recent prospective adverse event survey of a representative sample of 9408 acupuncture patients who were consulting members of the British Acupuncture Council. We analysed patient reports of demographic details, pathways to care, whether the National Health Service paid for their treatment, whether they had previously consulted a GP or hospital specialist for their main problem and whether they were consulting an acupuncturist for the first time. We separately analysed equivalent data from a survey funded by the Nuffield Provincial Hospital Trust undertaken in 1988.

Results

Seventy-four percent of patients were female, and with an average age of 51 years. Most commonly, patients had self-referred (39%), had previously consulted their doctor about their problem or symptom (78%), were paying for their own treatment (95%), and had received acupuncture before (87%). The most common main problem or symptom reported by patients was musculo-skeletal (38%), followed by psychological (11%), general (9%), neurological (8%) and gynaecological/obstetric (8%), while 5% of patients were seeking treatment for their general well-being. In comparing our data with that of the 1988 survey, we found a number of changes over time, in particular the proportion of musculo-skeletal conditions had dropped significantly (χ² = 17.36, d.f. = 1, p < 0.001), indicating a wider case mix amongst patients compared with those seeking care in 1988.

Conclusion

This evidence from acupuncture patients’ reports shows that musculo-skeletal problems provide the main reason for seeking treatment. The large dataset from this study provides a wealth of information and a fresh raft of questions which will inform future research and policy-making.

Introduction

More people are visiting acupuncturists in the UK than ever before and largely paying for these visits out-of-pocket. Paying out-of-pocket implies that there are important reasons for choosing acupuncture care, yet we have very little information about what problems or symptoms they are seeking help for, and whether they are consulting their doctor about their condition beforehand. There is increasing pressure on National Health Service decision-makers to provide alternative treatments within the NHS. However if acupuncture is to have more of a role in the health service, information about the patients that seek care in this field and for what conditions patients seek that care is crucial in order to inform purchasing decisions.

We know from a postal survey of over 5000 members of the adult general population conducted in 1998¹ that approximately 11% of the UK population had visited complementary practitioners from one of six established therapies (acupuncture, chiropractic, homeopathy, hypnotherapy, medical herbalism and osteopathy) within the previous year. From this study it was estimated that 7% of the adult population had visited an acupuncture practitioner within their lifetime and 1.6% had done so within the previous year. A more recent survey, conducted as part of the National Omnibus Survey also estimated that in 2001 1.6% of adults had consulted a practitioner of acupuncture in the preceding year.²

Patients who visit complementary practitioners in the UK have certain characteristics. More women than men are consulting, they tend to be more in the middle age ranges, and they seek care most commonly for musculo-skeletal problems.³ However, we have much less specific information about acupuncture patients. One of the best sources is from a survey of acupuncturists’ patient records conducted in 1995 by Wadlow and Peringer⁴ who found that acupuncturists also saw more women than men, and presented primarily with musculo-skeletal disorders. With the increasing popularity of acupuncture and the potential for its wider inclusion into the National Health Service, the more information we have about why people are seeking acupuncture care and who those people are, the better-informed decision makers can become.

In this paper we report the results of our analysis of the profiles of acupuncture patients who completed a recent survey of adverse events.⁵ With an unusually large dataset of over 9000 patients, a number required to meet our target for capturing potentially more rare adverse events, we have taken the opportunity of collecting and analysing data on the profiles of the patients, including their demographic details. Our primary focus in this paper has been the main problem or symptom reported by acupuncture patients, and we report these data along with associated patient characteristics.