Factors that influence patients’ decisions to discontinue with an acupuncture service—A qualitative study

Introduction: The Gateway Clinic in London has been an acupuncture service funded to manage NHS general practice referrals since 1990. Patients are referred by their general practitioners for a course of up to 10 treatments. However, as many as 40% of patients fail to complete the course. This qualitative study aimed to identify patients who had discontinued treatment and explored the factors that influenced their decision to discontinue. Methods: This was a prospective study of newly referred patients presenting to the clinic over a two month period. Those who discontinued acupuncture treatment and/or did not attend for treatment were subsequently identified using the clinic diary and were approached to take part in semi-structured telephone interviews. Results: Of 28 patients fitting the inclusion criteria, 14 agreed to take part and were interviewed using an interview schedule. Interviews were analysed using thematic analysis. The majority of patients reported experiencing positive outcomes from treatment. They did not consider themselves as having discontinued, either believing they had finished the course of treatment or that they would expect to receive future treatments. Patients reported experiencing barriers due to clinic availability or their work commitments. Conclusions: Patients discontinued with an acupuncture service despite reporting positive outcomes. Communication and clinic availability are the key factors that influence a patient’s' decision to discontinue. Session-by-session monitoring could encourage patient participation, improve outcome and reduce discontinuation. As the NHS in the UK and this acupuncture delivery is unique reasons for discontinuation of treatment in other countries is worth exploring as it may is likely to be different.