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THE WAY FORWARDTHE WAY FORWARD
Integration of Acupuncture into Mainstream Integration of Acupuncture into Mainstream MedicineMedicine
Jo Graham & Kate DukeJo Graham & Kate Duke
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
What is acupuncture and how does What is acupuncture and how does it work?it work?
EASTERNEASTERN ““Qi”Qi”
WESTERNWESTERN Release of opioid & Release of opioid &
other peptidesother peptides Activates Activates
hypothalamus & hypothalamus & pituitary glandpituitary gland
Alters immune Alters immune functionsfunctions
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Why Integration?Why Integration?
Increase in popularityIncrease in popularity AccessibilityAccessibility Safe and fewer side effects or other negative Safe and fewer side effects or other negative
effectseffects Proven effective modalityProven effective modality International acceptanceInternational acceptance Cost effectiveness & affordability??Cost effectiveness & affordability??
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
World Health Organisation World Health Organisation (WHO) Recognition(WHO) Recognition
WHO publications surrounding Traditional WHO publications surrounding Traditional
MedicineMedicine
WHO guidelines and strategies on Traditional WHO guidelines and strategies on Traditional
MedicineMedicine
IntegrationIntegration UtilizationUtilization
EvaluationEvaluation CooperationCooperation
New Zealand participation in WHO?New Zealand participation in WHO?
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Cost Effectiveness Cost Effectiveness ““Is Acupuncture for Pain Relief in General Practice Is Acupuncture for Pain Relief in General Practice
Cost Effective?”Cost Effective?”
Lindall S: Acupuncture in Medicine Dec1999 Vol17(2)Lindall S: Acupuncture in Medicine Dec1999 Vol17(2)
YES. Acupuncture is cost effective in certain pain YES. Acupuncture is cost effective in certain pain
conditionsconditions
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
“ “Cost Effectiveness analysis of a randomised trial of Cost Effectiveness analysis of a randomised trial of
acupuncture for chronic headache in primary care”acupuncture for chronic headache in primary care”
Wonderling D, Vickers A et al BMJ 15/03/04Wonderling D, Vickers A et al BMJ 15/03/04
Findings:Findings:
Improved Quality of LifeImproved Quality of Life
Decreased time off workDecreased time off work
Decreased medicationDecreased medication
Decreased visits to GPDecreased visits to GP
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Evidence of EffectivenessEvidence of EffectivenessNational Institutes of Health (NIH) National Institutes of Health (NIH)
Consensus Conference 1997Consensus Conference 1997
Post operative nausea and vomitingPost operative nausea and vomiting
Chemotherapy nausea and vomitingChemotherapy nausea and vomiting
Post operative dental painPost operative dental pain
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Reasonable Studies for Relief of PainReasonable Studies for Relief of Pain
Lateral epicondylitisLateral epicondylitis
DysmenorrhoeaDysmenorrhoea
FibromyalgiaFibromyalgia
Lower back painLower back pain
Post operative painPost operative pain
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Positive Clinical TrialsPositive Clinical Trials
AddictionAddiction
Carpal tunnel syndromeCarpal tunnel syndrome
OsteoarthritisOsteoarthritis
HeadacheHeadache
Stroke rehabilitationStroke rehabilitation
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Data in support of acupuncture is as Data in support of acupuncture is as
strong as for many Western medical strong as for many Western medical
therapiestherapies
Advantage is less adverse side effectsAdvantage is less adverse side effects
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
International Examples of International Examples of IntegrationIntegration
AustraliaAustraliaUSAUSAUKUK
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Addiction ServicesAddiction Services
Reduction in withdrawal Reduction in withdrawal symptoms, relapse rates & symptoms, relapse rates & an increase in retention an increase in retention ratesrates
NADA protocol is the NADA protocol is the cornerstone of over 800 cornerstone of over 800 detox centres worldwdedetox centres worldwde
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Reported successful clinical studiesReported successful clinical studies Obstetrics:- Obstetrics:- Induction, morning sickness, correction of Induction, morning sickness, correction of
abnormal foetal positions, deficient lactationabnormal foetal positions, deficient lactation
Gynaecology:- Gynaecology:- primary dysmenorrhoea, premenstrual primary dysmenorrhoea, premenstrual syndrome, infertility, menopausal syndromesyndrome, infertility, menopausal syndrome
Gynaecology & ObstetricsGynaecology & Obstetrics
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Chronic / Persistent PainChronic / Persistent Pain
Prevalence estimates range from 10.1% -Prevalence estimates range from 10.1% -
55.2% of the general population55.2% of the general population
Higher in females - usually musculoskeletal Higher in females - usually musculoskeletal
originorigin
Significant use of health care resourcesSignificant use of health care resources
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Clinical EvidenceClinical Evidence
““Limited evidence that acupuncture is more effective Limited evidence that acupuncture is more effective
than no treatment for chronic pain”than no treatment for chronic pain”
Systemic Review: Pain 2000 ; 86:217-225 Systemic Review: Pain 2000 ; 86:217-225
““Acupuncture found to be superior to no treatment”Acupuncture found to be superior to no treatment”
Vickers A et al Quality & Safety in Health Care2002;11:92-97Vickers A et al Quality & Safety in Health Care2002;11:92-97
““Most results favoured acupuncture”Most results favoured acupuncture”
Patel M et al International Journal of Epidemiology, Vol 18,900-Patel M et al International Journal of Epidemiology, Vol 18,900-
906 1989906 1989
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
Acupuncture at the Wellington Acupuncture at the Wellington Regional Pain ServiceRegional Pain Service
Available since 2000Available since 2000
Used in a variety of conditionsUsed in a variety of conditions
Limited serviceLimited service
Patients trialed 4-6 timesPatients trialed 4-6 times
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
THE WAY FORWARD: THE WAY FORWARD: Ideas for integrationIdeas for integration
Education Education ProgrammesProgrammes
Detoxification CentresDetoxification Centres Obstetrics and Obstetrics and
GynaecologyGynaecology
Stroke rehabilitationStroke rehabilitation Pain Clinics Pain Clinics Post operative Post operative
nausea and vomitingnausea and vomiting CancerCancer
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine
QUESTIONS??QUESTIONS??
Thank you for your timeThank you for your time
New Zealand School of Acupuncture & Traditional Chinese MedicineNew Zealand School of Acupuncture & Traditional Chinese Medicine