Predicting adherence to acupuncture appointments for low back pain: A prospective observational study

Felicity L. Bishop*, Lucy Yardley, Cyrus Cooper, Paul Little, George Lewith

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)
219 Downloads (Pure)


Background: Acupuncture is a popular form of complementary and alternative medicine (CAM), but it is not clear why patients do (or do not) follow acupuncturists' treatment recommendations. This study aimed to investigate theoretically-derived predictors of adherence to acupuncture.

Methods: In a prospective study, adults receiving acupuncture for low back pain completed validated questionnaires at baseline, 2 weeks, 3 months, and 6 months. Patients and acupuncturists reported attendance. Logistic regression tested whether illness perceptions, treatment beliefs, and treatment appraisals measured at 2 weeks predicted attendance at all recommended acupuncture appointments.

Results: Three hundred twenty-four people participated (aged 18-89 years, M = 55.9, SD = 14.4; 70% female). 165 (51%) attended all recommended acupuncture appointments. Adherence was predicted by appraising acupuncture as credible, appraising the acupuncturist positively, appraising practicalities of treatment positively, and holding pro-acupuncture treatment beliefs. A multivariable logistic regression model including demographic, clinical, and psychological predictors, fit the data well (χ 2 (21) = 52.723, p < .001), explained 20% of the variance, and correctly classified 65.4% of participants as adherent/non-adherent.

Conclusions: The results partially support the dynamic extended common-sense model for CAM use. As hypothesised, attending all recommended acupuncture appointments was predicted by illness perceptions, treatment beliefs, and treatment appraisals. However, experiencing early changes in symptoms did not predict attendance. Acupuncturists could make small changes to consultations and service organisation to encourage attendance at recommended appointments and thus potentially improve patient outcomes.

Original languageEnglish
Article number5
Number of pages12
JournalBMC Complementary and Alternative Medicine
Early online date3 Jan 2017
Publication statusPublished - 3 Jan 2017


  • Acupuncture
  • Adherence
  • Back pain
  • Health knowledge, Attitudes, Practice
  • Illness perceptions
  • Treatment beliefs


Dive into the research topics of 'Predicting adherence to acupuncture appointments for low back pain: A prospective observational study'. Together they form a unique fingerprint.

Cite this