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TCIM Research

Robin Ho (2023 RUNNER UP)

Published on 9/26/2023

Patients' perceptions on non-specific effects of acupuncture: Qualitative comparison between responders and non-responders

Robin S T Ho1Fai Fai Ho1Jon Adams2Holger Cramer2,3Brenda Leung2,4Lesley Ward2,5Yan Zhang2,6Vincent C H Chung1,2,7

1 Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
2 Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia.
3 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
4 Public Health, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
5 Department of Sport, Exercise and Rehabilitation, Faculty of Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
6 Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA.
7 School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong.


Background: Non-specific effect of acupuncture constitutes part of the overall effect generated via clinical encounter beyond needle insertion and stimulation. It is unclear how responders and non-responders of acupuncture experience non-specific effects differently. We aimed to compare their experiences in a nested qualitative study embedded in an acupuncture randomized trial on functional dyspepsia.

Purposive sampling was used to capture experience of responders (n=15) and non-responders (n=15) to acupuncture via individual in-depth interviews. Design and analysis followed a framework analysis approach, with reference to an existing model on acupuncture non-specific effects. Themes emerging outside of this model were purposefully explored.

Responders had a more trusting relationship with acupuncturist in response to their expression of empathy. In turn they were more actively engaged in lifestyle modifications and dietary advice offered by acupuncturists. Non-responders were not satisfied with the level of reassurance regarding acupuncture safety. They were also expecting more peer support from fellow participants, regarded that as an empowerment process for initiating and sustaining lifestyle changes.

Our results highlighted key differences in acupuncture non-specific effect components experienced by responders and non-responders. Positive non-specific effects contributing to overall benefits could be enhanced by emphasizing on empathy expression from acupuncturists, trust-building, offering appropriate explanations on safety, and organizing patient support groups. Further research on the relative importance of each component is warranted.