Feasibility and acceptability of group acupuncture in veterans with hepatitis C: A pilot study

Background: The Veterans Health Administration (VHA) system is the largest single provider for patients with hepatitis C (HCV) in the United States. Many individuals with HCV experience physical and psychologic symptoms, such as pain, fatigue, and depression. In addition, current antiviral therapy for HCV is long (24-48 weeks) and has many potential side-effects. Objectives: The purpose of this pilot study was to determine the acceptability, adherence, and feasibility of group acupuncture in order to inform the development of a larger randomized trial (RCT). The primary aim was to describe the experience of two groups of Veterans undergoing acupuncture for symptom management: (1) Veterans who have HCV and (2) Veterans who have HCV and were currently receiving antiviral therapy. Materials and Methods: This study used a prospective descriptive design that involved both quantitative and qualitative methods A total of 39 Veterans - 23 in the HCV-only group and 16 in the HCV/antiviral group - were enrolled. Participants received a maximum of 16 acupuncture sessions over 8 weeks. The main outcome measures were semistructured qualitative interviews, attendance, and recruitment records. Results: Quantitative results. Adherence proportion for the HCV-only group was 74.5% and 69.9% for the HCV/antiviral therapy group. Qualitative results: Five themes emerged: (1) study participation; (2) barriers to attending acupuncture sessions; (3) timing of acupuncture sessions; (4) receiving acupuncture in a group setting; and (5) engagement and attitude regarding the VHA system. Conclusions: This study suggests that a larger RCT, using group acupuncture would be feasible and acceptable to veterans. This article proposes several design modifications for an RCT.