Factors influencing participant compliance in acupuncture trials: An in-depth interview study

IntroductionLittle is known of acupuncture patients’ experiences and opinions of clinical trials, and what may influence their compliance when participating in an acupuncture trial.ObjectivesTo explore the potential factors that influence patients’ choice and determinants to participate in acupuncture clinical trials.MethodsTen qualitative, in-depth interviews were conducted with patients from acupuncture clinics in Beijing, who had previously participated in acupuncture clinical trials.ResultsFour main themes emerged from the interview data: effectiveness of the treatment, convenience of participating in a trial, doctor-participant communication, and participant acceptance of the treatment (or the trial). Effectiveness of acupuncture in treating the health condition was the most important factor for participant adherence. Pragmatics of treatment schedules, travel and attendance burden, together with confidence in the doctor’s ability additionally influenced trial and treatment compliance.ConclusionsIn-depth interviews suggest that treatment effectiveness, the pragmatics of attending treatment sessions, and the expertise and attitudes of acupuncturists are determining factors of participation and compliance in acupuncture clinical trials. Participants’ confidence in, and expectation of, acupuncture may facilitate compliance, while their fear of acupuncture and negative perceptions of the trial’s purpose may reduce treatment compliance. Compliance may be facilitated by enhanced doctor-patient communication, personalized treatment programs, and feedback on treatment outcomes.引言 目前学界对针灸患者参与临床试验的体验与看法，以及影响其参与针灸临床试验时依从性的相关因素仍知之甚少。 研究目标 本研究旨在探讨影响患者选择并参与针灸临床试验的潜在因素与决定条件。 研究方法 本研究对北京地区曾参与过针灸临床试验的针灸门诊患者开展了10例质性深度访谈。 研究结果 访谈数据归纳出四大核心主题：治疗有效性、试验参与便利性、医患沟通，以及患者对治疗（或试验）的接受度。其中，针灸针对所患病症的治疗有效性是影响患者依从性的最关键因素。此外，治疗日程安排的实际操作性、往返与就诊负担，以及对医师诊疗能力的信心，也会对试验与治疗依从性产生额外影响。 研究结论 本深度访谈结果显示，治疗有效性、就诊流程的实际操作性，以及针灸医师的专业素养与执业态度，是影响患者参与针灸临床试验及治疗依从性的决定性因素。患者对针灸的信心与预期可提升依从性，而对针灸的恐惧及对试验目的的负面认知则会降低治疗依从性。此外，优化医患沟通、制定个性化治疗方案，以及提供治疗结局反馈，均有助于提升患者依从性。