User Perceptions and Adverse Events of Self-Administered Direct Moxibustion in Korea: Secondary Analysis of 2019 Cross-Sectional Survey Data

Although previous research on moxibustion has primarily examined its clinical efficacy and safety, little is known about the real-world usage patterns, perceptions, and adverse events associated with self-administered direct moxibustion.Direct moxibustion involves higher temperatures than indirect forms.When performed by a non-professional user, this technique may elevate the risk of adverse events, particularly burns.Existing safety studies, however, do not distinguish between professional and self-administered treatments or between direct and indirect techniques.Therefore, this study aimed to investigate the usage patterns, perceptions, and adverse events in Korean self-users of direct moxibustion.We conducted a secondary analysis of a 2019 cross-sectional survey, analyzing responses from 190 individuals who reported self-administering direct moxibustion.Descriptive statistics were used to explore usage behaviors, perceived effects, and safety experiences.Independent t-tests were used to assess differences in satisfaction across demographic factors.To test the significance of the association between demographic factors and adverse event status, chi-square tests were performed.The majority of users (80%) used moxibustion at home, most commonly applying it on the legs, abdomen, and arms.The most commonly treated conditions were musculoskeletal conditions (49%) and gastrointestinal diseases (32%), with users reporting high perceived helpfulness.The primary motivation for use was general health maintenance (71%).Satisfaction was high, with an average score of approximately 4 out of 5, and no significant differences across gender, age, education, or income groups.Ease of use (83%) and low cost (79%) were viewed as key advantages.Despite these positive perceptions, 68% of users experienced at least one adverse event, most commonly itching (49%), blistering (40%), and burn scars (31%).Users with a college education or higher reported adverse events significantly more often than those with lower levels of education (P < 0.05).Self-administered direct moxibustion is widely perceived as accessible and beneficial for general health maintenance.Still, the high prevalence of skin-related adverse events underscores the urgent need for safety-focused educational materials tailored to self-administrators. Convenience sampling, analysis of preexisting data, and the Korea-specific context limit generalizability.Future research should include studies using a nationally representative sample and comparative studies across countries to better understand cultural influences on self-administered moxibustion and to explore globally applicable safety recommendations.