"it's Better in a Group Anyway": Patient Experiences of Group and Individual Acupuncture

Objectives: Chronic pain is prevalent, burdensome, and costly, and there are ethnic and racial disparities in treatment. Acupuncture is effective and safe, but access is limited. Group acupuncture can decrease cost and increase capacity by decreasing clinic space needs and increasing patient volume per acupuncturist; however, the effectiveness and patient acceptability of group and individual session acupuncture have never been directly compared. Design: The Acupuncture Approaches to Decrease Disparities in Pain Treatment (AADDOPT-2) study is a randomized comparative effectiveness trial of acupuncture for chronic pain. Semistructured in-depth interviews were conducted with a subset of patients enrolled in the trial. Settings/Location: Outpatient clinics in an urban, low income area serving a primarily black and Hispanic population. Subjects: Qualitative interviews were conducted with 46 patients; 23 in each arm of the AADDOPT-2 study. Interventions: Patients were randomized to receive either individual acupuncture or acupuncture delivered in a small group. Outcome measures: Transcripts of the interviews were analyzed using an inductive thematic framework to explore and compare the patient experience in group and individual settings. Results: Patients in both study arms valued the pain relief, improved quality of life, and relaxation experienced during acupuncture. Privacy and mixed-sex groups were cited as a concern by a minority of patients; however, most of those randomized to the group setting noted that these concerns abated after initiating treatment. Differences between arms included the depth of the relationship with the acupuncturist and misgivings related to the treatment space. Group dynamics varied; some groups fostered a supportive, therapeutic interaction, while others were more reserved. Conclusions: Patients in both arms valued their acupuncture experience. Participants described both positive and negative aspects of the group setting.