TY - JOUR
T1 - "it's Better in a Group Anyway"
T2 - Patient Experiences of Group and Individual Acupuncture
AU - Chuang, Elizabeth
AU - Hashai, Noa
AU - Buonora, Michele
AU - Gabison, Jonathan
AU - Kligler, Benjamin
AU - McKee, M. DIane
N1 - Funding Information:
This work was supported by the Patient-Centered Outcomes Research Institute (AD-1402-10857). The authors thank our patient stakeholders for their invaluable input into the interview guide and their insights into the presentation of these findings. We also thank the research acupuncturists and patient participants.
Publisher Copyright:
© Copyright 2018, Mary Ann Liebert, Inc. 2018.
PY - 2018/4
Y1 - 2018/4
N2 - Objectives: Chronic pain is prevalent, burdensome, and costly, and there are ethnic and racial disparities in treatment. Acupuncture is effective and safe, but access is limited. Group acupuncture can decrease cost and increase capacity by decreasing clinic space needs and increasing patient volume per acupuncturist; however, the effectiveness and patient acceptability of group and individual session acupuncture have never been directly compared. Design: The Acupuncture Approaches to Decrease Disparities in Pain Treatment (AADDOPT-2) study is a randomized comparative effectiveness trial of acupuncture for chronic pain. Semistructured in-depth interviews were conducted with a subset of patients enrolled in the trial. Settings/Location: Outpatient clinics in an urban, low income area serving a primarily black and Hispanic population. Subjects: Qualitative interviews were conducted with 46 patients; 23 in each arm of the AADDOPT-2 study. Interventions: Patients were randomized to receive either individual acupuncture or acupuncture delivered in a small group. Outcome measures: Transcripts of the interviews were analyzed using an inductive thematic framework to explore and compare the patient experience in group and individual settings. Results: Patients in both study arms valued the pain relief, improved quality of life, and relaxation experienced during acupuncture. Privacy and mixed-sex groups were cited as a concern by a minority of patients; however, most of those randomized to the group setting noted that these concerns abated after initiating treatment. Differences between arms included the depth of the relationship with the acupuncturist and misgivings related to the treatment space. Group dynamics varied; some groups fostered a supportive, therapeutic interaction, while others were more reserved. Conclusions: Patients in both arms valued their acupuncture experience. Participants described both positive and negative aspects of the group setting.
AB - Objectives: Chronic pain is prevalent, burdensome, and costly, and there are ethnic and racial disparities in treatment. Acupuncture is effective and safe, but access is limited. Group acupuncture can decrease cost and increase capacity by decreasing clinic space needs and increasing patient volume per acupuncturist; however, the effectiveness and patient acceptability of group and individual session acupuncture have never been directly compared. Design: The Acupuncture Approaches to Decrease Disparities in Pain Treatment (AADDOPT-2) study is a randomized comparative effectiveness trial of acupuncture for chronic pain. Semistructured in-depth interviews were conducted with a subset of patients enrolled in the trial. Settings/Location: Outpatient clinics in an urban, low income area serving a primarily black and Hispanic population. Subjects: Qualitative interviews were conducted with 46 patients; 23 in each arm of the AADDOPT-2 study. Interventions: Patients were randomized to receive either individual acupuncture or acupuncture delivered in a small group. Outcome measures: Transcripts of the interviews were analyzed using an inductive thematic framework to explore and compare the patient experience in group and individual settings. Results: Patients in both study arms valued the pain relief, improved quality of life, and relaxation experienced during acupuncture. Privacy and mixed-sex groups were cited as a concern by a minority of patients; however, most of those randomized to the group setting noted that these concerns abated after initiating treatment. Differences between arms included the depth of the relationship with the acupuncturist and misgivings related to the treatment space. Group dynamics varied; some groups fostered a supportive, therapeutic interaction, while others were more reserved. Conclusions: Patients in both arms valued their acupuncture experience. Participants described both positive and negative aspects of the group setting.
KW - acupuncture
KW - chronic pain
KW - musculoskeletal pain
KW - osteoarthritis
KW - qualitative methods
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U2 - 10.1089/acm.2017.0262
DO - 10.1089/acm.2017.0262
M3 - Article
C2 - 29446994
AN - SCOPUS:85045849953
SN - 1075-5535
VL - 24
SP - 336
EP - 342
JO - Journal of Alternative and Complementary Medicine
JF - Journal of Alternative and Complementary Medicine
IS - 4
ER -