New Zealand School of Acupuncture & Traditional Chinese Medicine THE WAY FORWARD Integration of Acupuncture into Mainstream Medicine Jo Graham & Kate Duke New Zealand School of Acupuncture & Traditional Chinese Medicine

What is acupuncture and how does it work? EASTERN “Qi” WESTERN Release of opioid & other peptides Activates hypothalamus & pituitary gland Alters immune functions New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Why Integration? Increase in popularity Accessibility Safe and fewer side effects or other negative effects Proven effective modality International acceptance Cost effectiveness & affordability?? Talk about who we are and what we represent. Determine credibility, education, and professionalism. Cost effectiveness: BMA recommended that further research should be conducted into this , particularly 4 those conditions in which acup has been identified as an effective form of care Further study BMJ 15/03/04, Acup 4 Chr HA improves QOL at a small additional cost, relatively cost effective cf with a no. of other interventions provided by the NHS New Zealand School of Acupuncture & Traditional Chinese Medicine

World Health Organisation (WHO) Recognition WHO publications surrounding Traditional Medicine WHO guidelines and strategies on Traditional Medicine Integration Utilization Evaluation Cooperation New Zealand participation in WHO? Each point needs to be reasoned out and clarified. New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Cost Effectiveness “Is Acupuncture for Pain Relief in General Practice Cost Effective?” Lindall S: Acupuncture in Medicine Dec1999 Vol17(2) YES. Acupuncture is cost effective in certain pain conditions New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine “Cost Effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care” Wonderling D, Vickers A et al BMJ 15/03/04 Findings: Improved Quality of Life Decreased time off work Decreased medication Decreased visits to GP New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Evidence of Effectiveness National Institutes of Health (NIH) Consensus Conference 1997 Post operative nausea and vomiting Chemotherapy nausea and vomiting Post operative dental pain NIH Concensus Conference on Acup1997 published findings in JAMA 1998 Nov New Zealand School of Acupuncture & Traditional Chinese Medicine

Reasonable Studies for Relief of Pain Lateral epicondylitis Dysmenorrhoea Fibromyalgia Lower back pain Post operative pain New Zealand School of Acupuncture & Traditional Chinese Medicine

Positive Clinical Trials Addiction Carpal tunnel syndrome Osteoarthritis Headache Stroke rehabilitation New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Data in support of acupuncture is as strong as for many Western medical therapies Advantage is less adverse side effects Ie New Zealand School of Acupuncture & Traditional Chinese Medicine

International Examples of Integration Australia USA UK New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Addiction Services Reduction in withdrawal symptoms, relapse rates & an increase in retention rates NADA protocol is the cornerstone of over 800 detox centres worldwde New Zealand School of Acupuncture & Traditional Chinese Medicine

Gynaecology & Obstetrics Reported successful clinical studies Obstetrics:- Induction, morning sickness, correction of abnormal foetal positions, deficient lactation Gynaecology:- primary dysmenorrhoea, premenstrual syndrome, infertility, menopausal syndrome New Zealand School of Acupuncture & Traditional Chinese Medicine

Chronic / Persistent Pain Prevalence estimates range from 10.1% -55.2% of the general population Higher in females - usually musculoskeletal origin Significant use of health care resources New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine Clinical Evidence “Limited evidence that acupuncture is more effective than no treatment for chronic pain” Systemic Review: Pain 2000 ; 86:217-225 “Acupuncture found to be superior to no treatment” Vickers A et al Quality & Safety in Health Care2002;11:92-97 “Most results favoured acupuncture” Patel M et al International Journal of Epidemiology, Vol 18,900-906 1989 New Zealand School of Acupuncture & Traditional Chinese Medicine

Acupuncture at the Wellington Regional Pain Service Available since 2000 Used in a variety of conditions Limited service Patients trialed 4-6 times New Zealand School of Acupuncture & Traditional Chinese Medicine

THE WAY FORWARD: Ideas for integration Education Programmes Detoxification Centres Obstetrics and Gynaecology Stroke rehabilitation Pain Clinics Post operative nausea and vomiting Cancer New Zealand School of Acupuncture & Traditional Chinese Medicine

New Zealand School of Acupuncture & Traditional Chinese Medicine QUESTIONS?? Thank you for your time New Zealand School of Acupuncture & Traditional Chinese Medicine