Designing an RCT of acupuncture for depression - Identifying appropriate patient groups: A qualitative study

Abstract

Background. Acupuncture is a popular complementary therapy choice for depression in the UK but the evidence base lags behind its usage. Further effectiveness trials are required; however, these need based on appropriate design for a complex intervention on a heterogeneous group of people. Aim. To identify subgroups of patients with depression who could be the focus of effectiveness trials. Methods. Qualitative research using in-depth interviews in UK primary care. In-depth interviews with 30 participants from three stakeholder groups: 10 acupuncture patients and 10 acupuncturists-to examine the reasons why acupuncture is used for depression and 10 physicians-to elicit who would be acceptable to refer into a trial of acupuncture for depression. Interviews were transcribed and analysed using a Framework approach. Results. The data have highlighted that the acceptability of particular treatments for depression is influenced by the individuals' illness career within their social context. In addition, the plausibility and associated acceptability of depression treatments are also closely tied to an individuals' explanatory model of their condition. Seven patient subgroups were identified who could potentially find acupuncture of particular interest and on which effectiveness trials could be focused. Conclusions. We have identified the main reasons why people seek acupuncture for depression and the circumstances in which physicians would be willing to refer for depression were it to prove effective. We have also set out a number of potential patient subgroups who may be particularly interested participating in a randomized controlled trail of acupuncture for depression. © The Author 2009. Published by Oxford University Press. All rights reserved.