Quotation Kwan, Yu Heng, Fong, Warren, Ang, Xiang Ling, Chew, Xiu Yan, Yoon, Sungwon, Tan, Chuen Seng, Tai, Bee Choo, Huang, Youyi, Bilger, Marcel, Phang, Jie Kie, Tan, Hui Chin, Quek, Su-An, Eng, Sing Yee Clara, Tan, Choy Tip, Tan, Choy Tip, Dong, Bao Qiang, Koh, Hwee Ling, Leung, Ying Ying, Ng, Swee Cheng, Fong, Kok Yong, Thumboo, Julian, Østbye, Truls. 2021. Facilitators of and barriers to implementing a traditional Chinese medicine collaborative model of care for axial spondyloarthritis: a qualitative study. Acupuncture in Medicine.


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Abstract

Conventional therapy may be inadequate for many patients with axial spondyloarthritis (axSpA). Traditional Chinese medicine (TCM) may be a viable alternative, but its effectiveness for axSpA is unknown. We are currently conducting a pragmatic randomised controlled trial (RCT) to investigate the effectiveness of a TCM collaborative model of care (TCMCMC), which combines usual rheumatologic care with acupuncture for patients with axSpA. This nested qualitative sub-study aims to identify facilitators of and barriers to the implementation of the TCMCMC. We conducted individual in-depth interviews with participants who had completed the acupuncture regimen to elicit opinions on the facilitators of and barriers to the implementation of the TCMCMC. The interviews were transcribed and analysed using thematic analysis. Twelve participants were included, with data saturation occurring after 10 interviews. The analysis revealed both a number of important ‘facilitators’ and ‘barriers’. Facilitators to the implementation of the TCMCMC included effectiveness of TCM to relieve symptoms, inadequacy of conventional treatment and positive social perceptions of TCM. Barriers included scepticism towards TCM, inability of TCM to provide instant relief, needle-related discomfort, variable effectiveness of TCM influenced by physicians’ skills and experience and the high cost of TCM. Recommendations to overcome barriers included further patient education about TCM. Policymakers should take into account the various feasibility factors identified in this study when developing and implementing a TCMCMC.

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Publication's profile

Status of publication Published
Affiliation WU
Type of publication Journal article
Journal Acupuncture in Medicine
Citation Index SCI
Language English
Title Facilitators of and barriers to implementing a traditional Chinese medicine collaborative model of care for axial spondyloarthritis: a qualitative study
Year 2021
URL http://journals.sagepub.com/doi/pdf/10.1177/09645284211009543
DOI http://dx.doi.org/10.1177/09645284211009543
Open Access N

Associations

People
Bilger, Marcel (Details)
External
Ang, Xiang Ling (Thong Chai Medical Institution, Singapore)
Chew, Xiu Yan (National University of Singapore, Singapore)
Dong, Bao Qiang (Liaoning University of Traditional Chinese Medicine, China)
Eng, Sing Yee Clara (Thong Chai Medical Institution, Singapore)
Fong, Kok Yong (Singapore General Hospital, Singapore)
Fong, Warren (Singapore General Hospital, National University of Singapore, Singapore)
Huang, Youyi (SingHealth, Singapore)
Koh, Hwee Ling (National University of Singapore, Singapore)
Kwan, Yu Heng (Duke-NUS Medical School, Singapore)
Leung, Ying Ying (Singapore General Hospital, Duke-NUS Medical School, Singapore)
Ng, Swee Cheng (Singapore General Hospital, Singapore)
Østbye, Truls (Duke-NUS Medical School, Singapore)
Phang, Jie Kie (Singapore General Hospital, Singapore)
Quek, Su-An (Thong Chai Medical Institution, Singapore)
Tai, Bee Choo (National University of Singapore, Singapore)
Tan, Choy Tip (Thong Chai Medical Institution, Singapore)
Tan, Choy Tip (Thong Chai Medical Institution, Singapore)
Tan, Chuen Seng (National University of Singapore, Singapore)
Tan, Hui Chin (Thong Chai Medical Institution, Singapore)
Thumboo, Julian (Duke-NUS Medical School, Singapore General Hospital, Singapore)
Yoon, Sungwon (Duke-NUS Medical School, Singapore)
Organization
Health Economics and Policy Group AB (Details)
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