General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study

Abstract

IntroductionUntil April 2016, acupuncture in the UK was recommended by the National Institute for Health and Care Excellence (NICE) as a potential treatment modality for three conditions, but use of this guidance in primary care is unknown. The aim of this study was to update the mapping of acupuncture on NICE clinical guidelines and to explore general practitioners’ (GPs’) awareness of those guidelines, as well as their views on and referral to acupuncture. It also examined the feasibility of research through electronic questionnaires administered to GPs. MethodsInitially, a literature search was conducted of NICE guidelines mentioning acupuncture (up to July 2015). Subsequently, a random sample of 57 GPs in North London was asked to complete an electronic survey. ResultsLiterature search identified one new “do not offer” recommendation (CG171: Urinary Incontinence). Four guidelines discussed acupuncture, concluding evidence was insufficient. The survey yielded 19 responses from 34 potential respondents. Patient demand appeared widespread but small; several GPs received enquiries but provided no access. The most common reason for enquiry was pain management. Importance assigned to guidance and awareness of guidance other than for pain varied significantly: GPs’ decision to offer access did not correlate with guideline awareness. GPs often expected recommendations where there were none. GPs professing least trust in guidance appeared more likely to offer acupuncture access. ConclusionNICE guidelines appeared not to reflect acupuncture provision in primary care. Electronic questionnaires are a feasible research method in primary care, although obtaining up-to-date contact details poses a challenge.