Barriers and facilitators for integrating acupuncture into referral procedures for patients with persistent somatic symptoms in Dutch primary care: A qualitative study

Introduction In the Netherlands, as in other Western European countries, healthcare providers face challenges in managing patients with persistent somatic symptoms. Current national guidelines focus on conventional treatments and largely exclude complementary approaches such as acupuncture. However, evidence suggests that acupuncture may benefit some patients and could serve as a complementary option within existing care. This study identified key barriers and facilitators to integrating acupuncture into Dutch primary care referral pathways for patients with persistent somatic symptoms. Methods A qualitative study was conducted, using 13 semi-structured interviews with healthcare providers, acupuncturists, and a researcher specialized in complementary therapies in primary care. An interview guide was developed to conduct the 20-30 minutes interviews. Thematic analysis was employed using Atlas.ti to identify key themes in the interview data. Results Two main barriers were identified: negative perceptions of acupuncture influencing referrals and limited collaboration between healthcare providers and acupuncturists. To support integration, one overarching facilitator was described, and the stakeholders suggested various strategies to promote the incorporation of acupuncture into healthcare practice. Conclusion This qualitative study demonstrated that although healthcare providers are aware of acupuncture as a treatment option, many hold negative perceptions and emphasize the need for stronger evidence-based knowledge before confidently making referrals. Strengthening collaboration and trust between healthcare providers and acupuncturists may be essential for enhancing patient care and recovery. To facilitate the integration of acupuncture and promote referrals in the Netherlands, incorporating acupuncture into healthcare providers’ training programs and medical guidelines may represent a crucial step forward.