Patient perspectives on outcomes after treatment with acupuncture

Objectives: To determine patients' experience of outcomes after acupuncture treatment. Design: A patient questionnaire followed by semistructured interviews. Setting: Acupuncture practices in York, England. Subjects: Questionnaires w ere distributed by 4 acupuncturists to all 132 of their patients over a 2-w eek period, 72 (55%) of whom responded. Of these, 11 patients were intervie wed. Interventions: Patients received normal care from their acupuncturists, all of whom were members of the British Acupuncture Council. Outcome measures: Patients reported on physical symptoms, emotional/mental symptoms, lifestyle changes, major life changes and inner life changes affe cting outlook and attitudes to health. Patients also reported on the extent they attributed change to acupuncture and what they valued about attending for treatment. Results: Primary reasons for attending were categorized by patients as phys ical symptoms (90%), mental and emotional problems (9%) and general health and well-being (1%). For physical symptoms, 75% of patients reported defini te change; for emotional and mental symptoms, 67%; lifestyle changes, 40%, major life changes, 27%; and for inner life changes, 54%. Over time, many o f the patients (42%) changed their primary reason for attending from their initial physical concerns, half of whom describing their new focus as relat ed to general health and well-being. Some emotional changes were experience d by 83% of patients, irrespective of the initial reason for attending. For all these changes, 58% of patients reported that they "substantially" attr ibuted the changes to acupuncture, and 25% "totally." The interviews provid ed additional data on the depth of the changes particularly for the longer term patients and on what they valued about treatment. Conclusions: Treatment with acupuncture results in a broad range of outcome s from physical and emotional change through to wider benefits involving th e patients' lifestyle, outlook, and attitude toward their health. Existing outcome measures are not adequate to assess these wider benefits. The resul ts suggest that patients experienced holistic benefits from acupuncture, an outcome that could be described as holism-in-action.