Predictors of acupuncture referral for chronic non-specific low back pain among medical practitioners in Malaysia.

Abstract

Introduction: Chronic non-specific low back pain (cnLBP) is a common primary care health issue. While acupuncture offers promising potential as a complementary treatment, its acceptance and integration into standard medical care for cnLBP remains inconsistent. This study investigated the predictors of acupuncture referral for cnLBP using the Theory of Planned Behaviour (TPB).

Materials and methods: This was a cross-sectional observational study. Medical practitioners were recruited from the Malaysian Medical Association via email invitations. Data were collected via a validated online questionnaire and analysed using SPSS, employing bivariate correlation and multiple linear regression analyses to examine the predictors of referral behaviour.

Results: A total of 389 medical practitioners were recruited. The respondents were predominantly general practitioners aged 35-44 years, with 10-19 years of clinical experience, and approximately 90.0% managed cnLBP. Despite the high awareness of the Traditional and Complementary Medicine Act (92.0%), only 33.2% referred patients to acupuncture. Few had acupuncture training (3.6%) or personal experience (7.7%), and services were available in 12.1% of the workplaces. Medical practitioners possess substantial knowledge about acupuncture treatment for cnLBP; however, misconceptions and uncertainties regarding its mechanisms persist. Using multiple linear regression analysis, the significant predictors of acupuncture referral were self-experience (β=0.151, p<0.01), attitude (β=0.189, p<0.001), and perceived behavioural control (β=0.101, p<0.05).

Conclusions: Despite positive attitudes and substantial awareness, barriers hinder the broader integration of acupuncture in cnLBP treatment. Targeted education, institutional support, and enhanced research collaborations are essential for improving referral rates and expanding the treatment options for cnLBP.