Feasibility and acceptability of a proposed trial of acupuncture as an adjunct to lifestyle interventions for weight loss in Polycystic Ovary Syndrome: a qualitative study

Abstract

BackgroundPolycystic Ovary Syndrome (PCOS) is a common female reproductive disorder with multiple manifestations. Weight management is a key therapeutic goal. Acupuncture is a potential adjunctive weight loss treatment in non-PCOS populations. We aimed to engage patients in co-design and assess the feasibility and acceptability of methods for a randomised controlled trial (RCT) on acupuncture and telephone-based health coaching for weight management in overweight or obese women with PCOS using qualitative methods.MethodsWe recruited women who had PCOS and were aged 18–45 years and with a body mass index of 25 kg/m2 and over, using social media. Two face-to-face focus group meetings and three semi-structured telephone interviews were conducted (n = 10). We analysed data using thematic analysis and aimed to compare and contrast motivations for joining the trial between women who were actively trying to conceive (n = 7) and not trying to conceive (n = 3). Attitudes to, knowledge and experiences of acupuncture; perceptions and attitudes towards the interventions in the RCT (real acupuncture, sham acupuncture and telephone-based health coaching); the outcomes of importance; and barriers and facilitators to successful trial recruitment and retention were collected.ResultsWomen were both acupuncture-naive and acupuncture-experienced. Overall, attitudes towards acupuncture were positive, and the trial design was acceptable with appointment flexibility requested. Ideal enrolment time, if women were trying to conceive, was six months prior to conception. Women supported three-month intervention and the use of sham acupuncture as a control. Financial incentives were not believed to be necessary, and women spoke of altruistic intentions in enrolling for such a trial. Women who were trying to conceive voiced a need for support from their family, health coaches, and peers. The telephone-based health coaching offered welcome support and accountability, noted as possible facilitators of weight loss.ConclusionsOur findings show that acupuncture is a likely acceptable adjunct to lifestyle interventions for weight loss in PCOS, and that a sham-controlled trial is feasible and acceptable to PCOS women. Further research is required in order to evaluate the efficacy of acupuncture together with lifestyle for weight management in PCOS.Electronic supplementary materialThe online version of this article (10.1186/s12906-018-2358-7) contains supplementary material, which is available to authorized users.

Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study

“…Our study methods have been previously described [25]. We conducted focus groups and semi-structured telephone interviews (offered to women through phone who were unable to attend the focus groups).…”

“…Therefore the aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS. This investigation is part of a larger qualitative study that assessed the feasibility and acceptability of a method for an RCT on acupuncture and lifestyle for weight management in women with PCOS [25].…”

IVF, acupuncture and mental health: a qualitative study of perceptions and experiences of women participating in a randomized controlled trial of acupuncture during IVF treatment

“…Some small studies in this field have reported increased well-being as being associated with a sense of regained self-control (de Lacey et al, 2009;Rayner et al, 2009;Sointu, 2006), and similar findings have been reported by participants having acupuncture in other medical fields (Ee et al, 2018;McPherson et al, 2006;Paterson and Britten, 2004).…”

Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study

“…Electro-acupuncture reduced muscle sympathetic nerve activity in PCOS women in one trial [27]. Our qualitative work indicates high levels of acceptance of acupuncture as a possible adjunct to lifestyle interventions for weight loss [30].…”