Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system.

BACKGROUND: An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. OBJECTIVE: To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. METHOD: A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. RESULTS: Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. CONCLUSION: Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.

The safety and efficacy of acupuncture for epididymitis protocol for a systematic review.

BACKGROUND: Epididymitis is a common disease in non-specific infections of the male reproductive system. According to the clinical incidence of acute epididymitis and chronic epididymitis, which is more common in chronic epididymitis. There are many clinical trials confirmed that acupuncture treatment can relieve pain and improve symptoms of epididymitis to some extent. In this systematic review, we aim to evaluate the effectiveness and safety of acupuncture for epididymitis. METHODS AND ANALYSIS: We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to November 2018. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of epididymitis. ETHICS AND DISSEMINATION: This systematic review will evaluate the efficacy and safety of acupuncture for epididymitis. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial. REGISTRATION NUMBER: PROSPERO CRD42018111348.

A Survey of Licensed Acupuncturists in the San Francisco Bay Area: Prevalence of Treating Oncology Patients.

BACKGROUND: Many cancer patients seek traditional Chinese medicine (TCM), the prevalence varying with diagnosis, comorbidities, and demographics. Interventions sought include acupuncture, massage, herbs, diet, and exercise, usually combined with conventional therapies. It is not known what proportion of TCM practitioners care for cancer patients, their cancer specific training or caseload, what interventions they employ, their outcomes, and their communication patterns with conventional oncologists. METHODS: A survey was mailed to all 2213 licensed acupuncturists in the 9-county San Francisco Bay Area gathering descriptive statistics. RESULTS: A total of 472 (21%) responded by mail or web-based Research Electronic Data Capture (REDCap) tool. Most respondents (77%) reported caring for patients with cancer, with 29% reporting having 6 to 10 years of practice experience, and 44.2% having 0 to 20 hours of training specific to the needs of patients with cancer. Improving quality of life was reported by 94% as what their treatment offered cancer patients as well as the area where treatment was felt to have the greatest impact. The most useful TCM modalities were acupuncture (98%), herbs (79%), diet (72%), moxibustion (46%), and meditation instruction (44%). Absence of adverse reactions was noted by 95%. Ninety-one percent reported "never" or "hardly ever" having been contacted by patients' oncologists to discuss treatment. CONCLUSIONS: Many acupuncturists seeing cancer patients have significant clinical experience and have sought specialized training. Improved communication is needed between TCM practitioners and oncologists sharing care of cancer patients.

Treatment of Chemotherapy-Induced Peripheral Neuropathy in Integrative Oncology: A Survey of Acupuncture and Oriental Medicine Practitioners.

OBJECTIVES: Complementary and alternative medicine is increasingly integrated into cancer care. We sought detail on the treatment of chemotherapy-induced peripheral neuropathy (CIPN) with acupuncture and oriental medicine (AOM) by surveying practitioners at integrative oncology (IO) sites across the United States. DESIGN: Online survey of licensed acupuncturists. SETTING/LOCATION: IO sites in the United States. SUBJECTS: Fifteen licensed acupuncturists who completed the survey between February 2014 and June 2014. OUTCOME MEASURES: Demographics, IO setting characteristics, AOM treatment characteristics, and practitioner-reported outcomes. RESULTS: Respondents reported an average of 31.3 ± 17.2 patients per week, and one-third (10.1 mean; 7.2 standard deviation [SD]) were treated for CIPN. Medical doctors (86.7%) were the most common providers with whom respondents worked. Traditional Chinese medicine style acupuncture was utilized by a majority of respondents (86.7%), and the most commonly used points were local, typically in the hands and feet, such as Ba Feng, Ba Xie, LV3, and LI4. In addition to acupuncture, nutritional advice was the most frequent auxiliary modality provided by respondents (85.7%). On average, respondents provided 12.75 ± 4.17 treatments for CIPN patients, and a majority (53%) reported treating patients once per week. Timing of the treatments relative to chemotherapy infusion was evenly distributed between "1-2 days after infusion" (60%), "at time of infusion" (53.3%), and "1-2 days before infusion" (46.7%). Sixty percent of respondents rated outcomes as "moderately successful with moderate improvement seen." CONCLUSION: This survey provides detail regarding IO sites using acupuncture for CIPN as well as real-world treatment patterns, including common point combinations, visit characteristics, and practitioner-reported outcomes. This information contributes to the emerging evidence on the use of acupuncture to address unmet needs of CIPN patients, and supports the development of best practice guidelines for the treatment of CIPN with acupuncture in the IO setting.

BIBLIOMETRIC ANALYSIS OF ACUPUNCTURE RESEARCH FRONTS AND THEIR WORLDWIDE DISTRIBUTION OVER THREE DECADES.

BACKGROUND: Considerable research has been conducted on acupuncture worldwide. This study chronologically examined the changing features and research fronts of acupuncture and elucidated the differences among the six most productive countries. METHODS: Bibliographic coupling is a powerful tool for identifying the research fronts of a field. Acupuncture-related publications worldwide and from the six most productive countries during 1983-2012 were retrieved from the Science Citation Index Expanded and Social Science Citation Index. To form the research fronts, the 100 most highly cited papers (HCPs) were clustered in terms of references shared. RESULTS: The United States had the highest proportion of HCPs. The effectiveness of acupuncture in areas such as relieving neck and back pain, migraines and headaches, and knee osteoarthritis symptoms was a predominant topic. Initially, the endogenous opioid peptide system was the primary research focus in the acupuncture mechanism research; however, during 1993-2012, researchers focused more on the functional magnetic resonance imaging of brain activity. In addition, acupuncture use and prevalence, the attitudes of health practitioners, and the effects of expectancy and belief were also major topics. Researches from Western countries, including the United States, England, and Germany, showed more interest in clinical trials and economic- and ethics-related studies, whereas those from East Asian countries including China, Japan, and South Korea focused more on mechanism research. CONCLUSION: Western countries dominated the research fronts of acupuncture. The patterns of the research fronts varied worldwide, indicating continuity and innovation in research in each country.

Communication of professional literature amongst European Acupuncturists affiliated to the ETCMA (European Traditional Chinese Medicine Association): explorative survey amongst Traditional Chinese Medicine practitioners in Europe.

OBJECTIVES: The primary aim of the survey was to explore the information needs and information seeking behavior amongst the ETCMA members concerning professional literature (scientific as well as practical background knowledge). METHODS: A web-based survey comprising of 18 questions with a total of 25 items was carried out in 15 affiliated associations in 14 countries in June 2012. The survey consisted out of 4 parts: (1) Demographics, (2) Level of interest in and availability of professional literature, (3) Insight, needs and opinions on EBM (Evidence Based Medicine), and (4) Awareness of the science workshop at the TCM Rothenburg Congress. RESULTS: 2590 (25%) from 10,428 members completed the questionnaire, of which 58.8% was female. More than 50% of the respondents from eleven out of fourteen countries indicate an interest in more education on reading scientific literature. Case studies (range 3.19/4-3.86/4) are preferred compared to scientific (range 2.78/4-3.59/4) or philosophical knowledge (range 3.0/4-3.56/4). Exchange with colleagues (range 2.95/4-3.64/4) is preferred compared to deepening knowledge (range 2.57/4-3.05/4) in the theoretical spectrum. 61% has no knowledge of the EBM model and base clinical decisions on personal experience (range 3.47-3.82) and practical skills (range 3.47-3.74) compared to clinical practice guidelines (range 2.6-3.27). CONCLUSIONS: Due to heterogeneity in structure and size of the affiliated associations no strict conclusions can be made. We can conclude though that TCM practitioners rely mostly on practical knowledge and have less tendency toward more scientifically oriented models like the EBM model. We find this reflected in information needs as well as information seeking behavior patterns.

Determining attitudes toward acupuncture: a focus on older U.S. veterans.

OBJECTIVE: To explore whether factors related to attitudes toward acupuncture use in a population of older veterans is similar to previously identified motivators for nonveterans. METHODS: A sample of veterans was asked to complete a questionnaire, which included questions on sociodemographic traits, history of acupuncture, chronic diseases, and the Health Belief Model (HBM). Data reduction was performed by using principal components analysis to identify major factors among the HBM responses. Linear regression was performed to evaluate variables that may contribute to attitudes toward acupuncture. RESULTS: There were 402 completed questionnaires. Principal components analysis yielded three significant factors. Linear regression resulted in a model that explained 35% of the variance for positive attitudes toward acupuncture: Age, race, religion, access to acupuncture, self-efficacy for nonpharmacologic treatments, and the presence of one or more physical and mental chronic health condition were significantly related to positive attitudes toward acupuncture. CONCLUSIONS: Factors related to attitudes toward acupuncture were very similar to factors identified in other literature for nonveterans, with the exception of income and education. The findings suggest that availability of treatment influences attitudes toward acupuncture.

An epidemiologic analysis of clinical practice guidelines for non-arthroplasty treatment of osteoarthritis of the knee.

PURPOSE: To analyze the current practice patterns of non-arthroplasty treatment of knee osteoarthritis (OA) and to assess the impact of the American Academy of Orthopaedic Surgeons clinical practice guidelines on the management of OA of the knee, particularly as they relate to the use of arthroscopic treatment. METHODS: The United Healthcare Database (2004-2009, 11 million patients, 216 million records) was used for the study and was searched using Boolean language for International Classification of Diseases, Ninth Edition, Clinical Modification and Current Procedural Terminology, fourth revision codes. A reference group was defined as patients treated with knee arthroplasty in 2009 and diagnosed with knee OA in the same record. Clinical practice patterns in the 5 years preceding arthroplasty were analyzed in this group. RESULTS: The reference group consisted of 12,806 patients undergoing total knee arthroplasty in 2009 with a documented diagnosis of OA at the time of surgery, with prior nonoperative treatment strategies analyzed during the preceding 5 years (2004-2009); 10.0% of patients were prescribed physical therapy specific to OA, 2.6% received an unloader brace, 0.52% underwent acupuncture, 43.5% were administered intra-articular corticosteroids, and 15.4% received viscosupplementation injections. During the 5 years before arthroplasty, 2,505 patients (19.6%) underwent arthroscopy and debridement/lavage, 35% of whom did not have a diagnosis code for mechanical pathology. Within 1 year of knee arthroplasty, 2,028 of the 2,505 knee arthroscopies (80.9%) were performed. CONCLUSIONS: The findings show that significant gaps do exist between the evidence-based American Academy of Orthopaedic Surgeons recommendations and actual practice patterns in the United States between 2004 and 2009. LEVEL OF EVIDENCE: Level IV, diagnostic study.

Utilisation of complementary and alternative medicine (CAM) practitioners within maternity care provision: results from a nationally representative cohort study of 1,835 pregnant women.

BACKGROUND: There is little known about women's concurrent use of conventional and complementary health care during pregnancy, particularly consultation patterns with complementary and alternative medicine (CAM). This study examines health service utilisation among pregnant women including consultations with obstetricians, midwives, general practitioners (GPs) and CAM practitioners. METHODS: A sub-study of pregnant women (n=2445) was undertaken from the nationally-representative Australian Longitudinal Study on Women's Health (ALSWH). Women's consultations with conventional practitioners (obstetricians, GPs and midwives) and CAM practitioners for pregnancy-related health conditions were analysed. The analysis included Pearson chi-square tests to compare categorical variables. RESULTS: The survey was completed by 1835 women (response rate = 79.2%). A substantial number (49.4%) of respondents consulted with a CAM practitioner for pregnancy-related health conditions. Many participants consulted only with a CAM practitioner for assistance with certain conditions such as neck pain (74.6%) and sciatica (40.4%). Meanwhile, women consulted both CAM practitioners and conventional maternity health professionals (obstetricians, midwives and GPs) for back pain (61.8%) and gestational diabetes (22.2%). Women visiting a general practitioner (GP) 3-4 times for pregnancy care were more likely to consult with acupuncturists compared with those consulting a GP less often (p=<0.001, x2=20.5). Women who had more frequent visits to a midwife were more likely to have consulted with an acupuncturist (p=<0.001, x2=18.9) or a doula (p=<0.001, x2=23.2) than those visiting midwives less frequently for their pregnancy care. CONCLUSIONS: The results emphasise the necessity for a considered and collaborative approach to interactions between pregnant women, conventional maternity health providers and CAM practitioners to accommodate appropriate information transferral and co-ordinated maternity care. The absence of sufficient clinical evidence regarding many commonly used CAM practices during pregnancy also requires urgent attention.

Acupuncture point localization varies among acupuncturists.

BACKGROUND: Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. MATERIAL AND METHODS: Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DÄGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant's arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. RESULTS: The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm(2). The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. CONCLUSION: Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies.

Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK.

BACKGROUND: The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. METHODS: Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. RESULTS: Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. CONCLUSIONS: Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors.

Acupuncturists' perspectives on outcome measures to evaluate acupuncture care for chronic low back pain.

OBJECTIVES: To examine Australian acupuncturists' perspectives of: chronic low back pain outcome domains; their use of outcome measures to assess chronic low back pain; and their attitudes and perceptions of barriers to using the existing measures to evaluate acupuncture care for chronic low back pain. DESIGN: A postal questionnaire was used in a cross-sectional survey. PARTICIPANTS: 359 randomly selected Australian acupuncturists. RESULTS: 139 questionnaires were returned (response rate: 38.7%). The respondents' demographic characteristics were similar to Australian Bureau of Statistics acupuncturist demographic data. Overall, acupuncturists endorsed a broad approach to assessing acupuncture care for chronic low back pain. However, they had typically used pain severity measures but generally did not use other types of measures. Acupuncturists tended to hold positive attitudes towards using outcome measures. The principal barriers acupuncturists perceived to using outcome measures concerned doubts about whether the concepts which underpin acupuncture practice had been explicitly articulated and whether the available measures capture the specific context and particular outcomes of acupuncture care for chronic low back pain. IMPLICATIONS: The findings of this study suggest that a broad range of outcome measures are required to adequately assess chronic low back pain acupuncture care outcomes. While numerous outcome measures have been developed that are relevant to chronic low back pain care, whether these measures are appropriate for use by acupuncturists is unclear. Further studies are warranted to explore if established outcome measures are useful to evaluate chronic low back acupuncture care.

Diagnoses and visit length in complementary and mainstream medicine.

BACKGROUND: The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. METHODS: Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. RESULTS: The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC) were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. CONCLUSIONS: CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to specific diagnoses. Between CM practices differences were found on specific domains of complaints. Visit length was much longer in CM practices compared to mainstream GP visits, and such ample time may be one of the attractive features of CM for patients.

Use of traditional Chinese medicine among pregnant women in Taiwan.

OBJECTIVE: To investigate the patterns of traditional Chinese medicine (TCM) use among pregnant women in the National Health Insurance program in Taiwan. METHODS: Women who gave birth in Taiwan in 2006 were identified from the National Health Insurance Research Database. Claims for reimbursement following TCM ambulatory visits by these women were analyzed. RESULTS: In total, 20.9% of women in the study who gave birth in 2006 used TCM during pregnancy, with older women more likely to utilize this form of care (23.9% of women >35 years of age vs 16.2% of women <20 years of age). There was an increase in the use of TCM for pregnancy-related problems such as hypertension (194 women before pregnancy vs 2163 during) and nausea/vomiting (220 women before vs 1648 during). The predominant modality (88.4%) of TCM treatment during pregnancy was herbal preparation. CONCLUSION: Traditional Chinese medicine, with the exception of acupuncture, is popular among pregnant women in Taiwan. In addition to its efficacy, the safety of TCM during pregnancy requires future investigation.

[Acupuncture. Basics, practice, and evidence]. / Akupunktur: Grundlagen, Praxis und Evidenz.

Acupuncture, which originated with traditional Chinese medicine, has been increasingly used in Western medicine over the last three decades. A huge body of scientific literature reports the physiological and clinical effects of acupuncture. In Germany, about 30,000 physicians apply acupuncture at least occasionally, and German health insurances reimburse acupuncture treatment for chronic low back pain and osteoarthritis of the knee. This overview discusses the most important historical, theoretical, practical, and scientific aspects of acupuncture in general, with a special look at anaesthesia. Regarding anaesthesia, supportive acupuncture treatment is performed for postoperative pain, anxiolysis, and postoperative nausea and vomiting, based on promising results of rigorous randomised trials. However, many unresolved questions remain, such as regarding specificity of concepts, indications, and optimum dose.

Incorporating acupuncture in a university-based family medicine center: lessons learned.

OBJECTIVES: To evaluate the utilization, financial costs, and benefits of incorporating acupuncture into a university-based family medicine center. DESIGN: Retrospective billing records review. SETTING: An academic family medicine center located within a university-based medical center. SUBJECTS: The entire population of consecutive patients seen in an acupuncture clinic from April, 2002 through October, 2006. OUTCOME MEASURES: Patient characteristics, number and types of visits, and charges and collections. METHODS: Analysis of de-identified, electronic billing records. RESULTS: During the 4(1/2)-year study period, 788 unique patients were seen, accounting for a total of 4953 visits. The most common clinical conditions treated were back pain, headache, and neck pain. Mean charge and collection per visit was $82 and $53, respectively. Mean annual clinic revenues and expenses were $58,653 and $74,223, respectively. CONCLUSIONS: The authors' experience with an acupuncture clinic within an academic medical center has been generally positive, but we have not been able to turn a profit within the first 4(1/2) years of operation. Advantages of including physician-acupuncturists include improved patient access to third-party payers for clinical services, and possibly better acceptance by physician colleagues and the larger medical center system. Physician-acupuncturists, however, tend to have higher salary and liability costs associated with their services. Incorporating licensed acupuncturists allows for improved access to patients as well as lower operating expenses. We postulate that patients are generally more willing to pay cash for acupuncture services provided by a licensed acupuncturist compared to a physician, whose services are generally expected to be covered by medical insurance. Our findings suggest that incorporating acupuncture into existing medical practices may benefit patients, providers, the clinic as a whole, and the larger community, but the profit margin associated with providing acupuncture in these settings is likely to be negative or slim.

Complementary and alternative medicines in ankylosing spondylitis: a cross-sectional study.

Prevalence of dietary complementary and alternative medicine (CAM) and consultation with a CAM practitioner was examined in a cross-sectional study of 75 AS patients. Seventy one of 75 (94.7%) study participants reported previous or current CAM use. Among these AS patients, 44 (72.1%) reported dietary CAM use and 27 (36.0%) were seeing a CAM practitioner at the time of study. Of 89 dietary CAM, 50 (56.4%) were perceived to be of slight or no benefit, and only 10 (11.2%) were initiated by a CAM practitioner. Compared with non-users, current dietary CAM users were more likely to be female (OR 6.5; 95% CI, 1.8-23.9). Patients attending a CAM practitioner were more likely to have university education (OR 5.7; 95% CI, 1.5-21.9) and higher BASDAI (OR 1.3; 95%CI, 1.0-1.7). Despite low rates of perceived benefit, dietary CAM use and CAM practitioner attendance is common among AS patients.

Acupuncture use among people living with HIV/AIDS in Northern Thailand: motives, barriers, and attitudes.

OBJECTIVE: The present cross-sectional, qualitative study examined attitudes toward and motives for acupuncture use and disuse among people with HIV/AIDS (PHA) in Northern Thailand. MATERIAL AND METHOD: Over a seven-day period, interviews were conducted in Thai by two research assistants and two PHA volunteers on 20 patients. RESULT: The social support, psychological well-being, clinical symptoms, and analgesic avoidance were the primary motives for use among acupuncture users. Among non-acupuncture users, better health status, instrument aversion, lower effectiveness, high perceived risk of deleterious interactions with antiretroviral therapy, inferiority to conventional medicine, and lack of time and knowledge were the main reasons for disuse. Nineteen out of twenty patients expressed positive or neutral attitudes toward acupuncture. Further study is recommended to explore long-term benefits and ramifications of acupuncture as a substitute for pharmacological pain interventions. CONCLUSION: Though acupuncture is not a panacea that is recommended for everyone, health care provide.rs should educate patients about acupuncture's prophylactic benefits, offer services at more convenient times, and be aware of the potential barriers of acupuncture use.