How and why patients use acupuncture: an interpretive phenomenological study.

INTRODUCTION The usual drivers of health care provision, namely efficacy and cost, might be expected to drive down the use of Complementary and Alternative Medicines (CAMs), given the relative paucity of evidence of efficacy for many CAMs. Usage of CAMs remains extensive and little attention has been given to explaining this paradox. This paper explores how patients integrate acupuncture, as a CAMs exemplar, within their personal schemes of health care. METHODS An interpretive phenomenological approach underpinned the inquiry, which gathered data from in-depth interviews with 12 participants who had recently consulted acupuncturists. Thematic analysis was conducted using a constant comparison methodology. FINDINGS Participants mostly accessed acupuncture for musculoskeletal and pain-related conditions. Usage was often initially motivated by dissatisfaction with conventional health care, perceptions that the source of the problem had not been addressed, and sometimes was due to negative experiences with medical professionals. Previous positive outcomes with acupuncture motivated more extensive use, as did personal health ideologies. Acupuncture was viewed to be appropriate for treating chronic and quality of life health issues, while treatment-associated cost was identified as a barrier to access. CONCLUSIONS CAMs usage has been explained variously by 'push' and 'pull' factors; however, this study has shown that reasons for patient use of acupuncture may be complex and change over time. This qualitative study suggests that acupuncture fulfils specific health needs unmet in conventional health care, but also that patients view CAMs treatment as part of a broader and more pluralistic scheme of health care.