About the Foundation
The Foundation is a small yet dynamic organisation committed to promoting high quality research into our understanding of acupuncture as well as evaluating the benefits, the cost effectiveness and the safety. Our primary goal is to develop and improve the practice of Chinese medicine and to work towards a more central role for acupuncture within the UK’s national health care system. The Foundation is involved in a number of research projects, the largest of which is a pragmatic randomised controlled trial evaluating the cost effectiveness of acupuncture in the treatment of low back pain. Adverse events following acupuncture are being evaluated in two studies, one a prospective survey of acupuncturist, the other a survey of patients’ experience of adverse events. The Foundation has also had an interest in women’s health which has developed to the point where a preliminary study has been launched exploring the role of acupuncture for women with menorrhagia. The Foundation is also exploring the diagnostic categories of traditional Chinese medicine with the aim of establishing levels of concordance between practitioners.
History of the Foundation
The Foundation was established in 1991 to provide an organisational base for promoting research into acupuncture:
“The goal of the Foundation is, through research and education, to bring the traditional Chinese system of acupuncture more centrally into the national health care system”.
The first period of the Foundation’s existence was focused on the professional acupuncture community and in particular on the need for acupuncturists to be engaged in research both for the benefits of patients and as part of a process of professionalisation. This position was clearly articulated by our first Research Director.
The Foundation became more established with the appointment as Research Director in 1993. His first step was to survey the membership of the British Acupuncture Council and to elicit current attitudes and needs in the area of research. This survey (Fitter & Blackwell, 1993) led to a seminal short training programme in acupuncture research (known as the STAR programme) for acupuncture practitioners. In turn this programme led to a number of subsequent training activities with the participants subsequently conducting their own multi-centred outcomes project where variations in outcomes following acupuncture were investigated (Luty et al 1995, MacPherson & Fitter 1999).
The first clinically based study involved a small feasibility project investigating the use of acupuncture in the treatment of low back pain (Fitter & MacPherson 1995). This project led to a subsequent pilot study where 20 patients participated in a more thorough investigation (MacPherson et al 1999). Based on this, the Foundation in collaboration with Kate Thomas of the Medical Care Unit of Sheffield University set up the York Acupuncture Back Pain Project, funded by the NHS to undertake a pragmatic randomised controlled trial to evaluate the clinical and cost benefits of acupuncture for chronic low back pain (Thomas et al 1999, MacPherson 1999d).
For acupuncturists, there is both an “inner” perspective on research where the aim can be more towards developing practice for the benefit of patients (improving) or an “outer” perspective demonstrating benefits for an external audience (proving) (Fitter, 1997). Mike Fitter and Kate Thomas in collaboration have investigated a number of methodological issues that are of particular importance for research into complementary medicine (Fitter & Thomas 1997, Thomas & Fitter 1997). Emerging themes for research include ensuring that the focus is on studying the therapy as it is actually practised (MacPherson 2000), that the integrity of the therapy is honoured (Wheeler & MacPherson 2000), and that the outcomes of treatment are more diverse and complex than quantitative measures alone can demonstrate (Fitter 1996). In this context she undertook her MSc on patient perspectives on outcome following acupuncture and this study has been submitted for publication (Gould & MacPherson 2000).
A major project for the Foundation has been the collaborative work with the British Acupuncture Council in setting up and running the Acupuncture Research Resources Centre (ARRC) co-ordinated by her between 1994 and 1998. ARRC provided a national information service on acupuncture research and produced a national Directory of Acupuncturists in Research and an acupuncture database known as Arrobas (Gould 1997b). With Foundation staff, ARRC also organised annual symposiums for researchers to gather and present the results of their investigations (Gould 1996b, Gould 1997a, Gould 1999). In 1998, the Acupuncture Research Resources Centre transferred to Exeter University where it continues its important role in supporting research and providing information on acupuncture.
He wrote an early paper on adverse events involving Chinese herbal medicines (1996). More recently the Foundation has focused on studying adverse events following acupuncture (MacPherson & Gould 1998, MacPherson 1998, MacPherson 1999a, MacPherson 1999c, MacPherson & Lewith 2000) and setting up a prospective survey of practitioner reports of significant events and minor transient reactions to acupuncture. This project has led to plans for a survey of patients’ experiences of adverse events following acupuncture.
The Foundation has developed a number of good working relationships with other individuals and organisations in the field, including the Research Council for Complementary Medicine, and centres and/or staff at the Universities of Exeter, Glasgow, Sheffield, Southampton, Westminster and York. The staff of the Foundation have also participated in a number of national initiatives that involve promoting or developing the role of complementary medicine in the UK. These initiatives include the Labour Party’s 1994 position paper “From Prescription to Facilitation” and the Research Council for Complementary Medicine’s national audit project. The Foundation also contributed to the Prince of Wales initiative with the Foundation for Integrated Medicine (FIM), widening the debate on research strategies for complementary medicine (Thomas & Fitter 2000). In turn this has led to the Foundation providing evidence for the Science and Technology Committee of the House of Lords who will be reporting to the Government early in 2001.