Research data, funding and education have been identified as the main difficulties in Acupuncture research by the World Health Organization and experts in the field. These barriers to the integration of Acupuncture and Herbal Medicine (AHM) in primary care, health coverage and accessibility are interconnected. AHM is a personalized medicine system and research methods applied by biomedical science (BMS) are insufficient in AHM research. This delays AHM integration as policy makers rely on research data for decision making. Changes in AHM education to unify degrees, establish BMS pre-requisites, base the curricula on Classical Chinese Medicine and offer research education, may produce AHM providers who deliver high quality AHM research and benefit all stakeholders. Raising the bar in AHM to offer a sole DAOM and a subsequent clinical and research PhD degree may be the next step in AHM education to improve the overall situation. This literature review explores the current state of AHM research and education to identify opportunities for improvement.
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References
1.
World Health Organization. Regional Office for the Western Pacific. Chiến Lược Y Học Cổ Truyền Của Tổ Chức Y Tế Thế Giới: 2014–2023 [WHO Traditional Medicine Strategy: 2014–2023]. WHO Regional Office for the Western Pacific. 2013. Online document at: https://iris.wpro.who.int/handle/10665.1/11340 Accessed July21, 2022.
2.
World Health Organization. WHO Global Report on Traditional and Complementary Medicine 2019.World Health Organization; 2019. Online document at: https://apps.who.int/iris/handle/10665/312342 Accessed November13, 2021.
3.
GangWJ, XiuWC, ShiLJ, et al.Factors associated with the magnitude of acupuncture treatment effects (FAMOUS): A meta-epidemiological study of acupuncture randomised controlled trials. BMJ Open, 2022; 12:e060237.
4.
MirzaR, PunjaS, VohraS, GuyattG. The history and development of N-of-1 trials. J R Soc Med, 2017; 110:330–340.
5.
IyiohaI. Law's dilemma: Validating complementary and alternative medicine and the clash of evidential paradigms. Evid Based Complement Alternat Med, 2011; 2011:1–10.
6.
BaarsEW, HamreHJ. Whole medical systems versus the system of conventional biomedicine: A critical, narrative review of similarities, differences, and factors that promote the integration process. Evid Based Complement Alternat Med, 2017; 2017:1–13.
HoL, KeFYT, WongCHL, et al.Low methodological quality of systematic reviews on acupuncture: A cross-sectional study. BMC Med Res Methodol, 2021; 21:237.
9.
ShuaiP, ZhouXH, LaoL, LiX. Issues of design and statistical analysis in controlled clinical acupuncture trials: An analysis of English-language reports from Western journals. Stat Med, 2012; 31:606–618.
10.
LaoL, HuangY, FengC, et al.Evaluating traditional Chinese medicine using modern clinical trial design and statistical methodology: application to a randomized controlled acupuncture trial. Stat Med, 2012; 31(7):619–627. doi: 10.1002/sim.4003.
11.
WielandLS, BrassingtonR, MacdonaldG. Barriers to the registration and conduct of Cochrane systematic reviews of traditional East Asian medicine therapies. Eur J Integr Med, 2019; 32:101008.
12.
ManheimerE, WielandS, KimbroughE, et al.Evidence from the Cochrane Collaboration for traditional Chinese medicine therapies. J Altern Complement Med, 2009; 15:1001–1014.
13.
LiuJP, HanM, LiXX, et al.Prospective registration, bias risk and outcome-reporting bias in randomised clinical trials of traditional Chinese medicine: An empirical methodological study. BMJ Open, 2013; 3:e002968.
14.
HammerschlagR, MilleyR, ColbertA, et al.Randomized controlled trials of acupuncture (1997–2007): An assessment of reporting quality with a CONSORT- and STRICTA-based instrument. Evid Based Complement Alternat Med, 2011; 2011:1–25.
15.
DengS, ZhaoX, DuR, et al.Is acupuncture no more than a placebo? Extensive discussion required about possible bias. Exp Ther Med, 2015; 10:1247–1252.
16.
KaptchukTJ. Placebo effects in acupuncture. Med Acupunct, 2020; 32:352–356.
17.
ZhengC, WanX, XuX, et al.General issues in clinical research of acupuncture and in vitro fertilization. Evid Based Complement Alternat Med, 2020; 2020:1–5.
18.
BirchS, LeeMS, KimTH, AlraekT. Historical perspectives on using sham acupuncture in acupuncture clinical trials. Integr Med Res, 2022; 11:100725.
19.
CogoE, SampsonM, AjiferukeI, et al.Searching for controlled trials of complementary and alternative medicine: A comparison of 15 databases. Evid Based Complement Alternat Med, 2011; 2011:858246.
20.
MacPhersonH, MaschinoAC, LewithG, et al.Characteristics of acupuncture treatment associated with outcome: An individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials. PLoS One, 2013; 8:e77438.
21.
ShangC. Prospective tests on biological models of acupuncture. Evid Based Complement Alternat Med, 2009; 6:31–39.
22.
PritzkerS, HuiKK. Building an evidence-base for TCM and integrative east-west medicine: A review of recent developments in innovative research design. J Tradit Complement Med, 2012; 2:158–163.
23.
KhalsaPS, PearsonNJ. Financial support for research training and career development in complementary and alternative medicine from the National Institutes of Health. J Manipulative Physiol Ther, 2007; 30:483–490.
24.
MenardMB, WeeksJ, AndersonB, et al.Consensus recommendations to NCCIH from research faculty in a transdisciplinary academic consortium for complementary and integrative health and medicine. J Altern Complement Med, 2015; 21:386–394.
25.
MillsPJ, PatelS, BarsottiT, et al.Advancing research on traditional whole systems medicine approaches. J Evid Based Complementary Altern Med, 2017; 22:527–530.
26.
LamTP, MakKY, LamKF, et al.Five-year outcomes of western mental health training for Traditional Chinese Medicine practitioners. BMC Psychiatry, 2016; 16:363.
27.
GrayAC, SteelA, AdamsJ. A critical integrative review of complementary medicine education research: Key issues and empirical gaps. BMC Complement Altern Med, 2019; 19:73.
28.
WongE, GasterB, LeeS. East meets West: Current issues relevant to integrating Chinese medicine. Chin Med, 2012; 7:20.
29.
ZhangW, PritzkerSE, HuiKK. Factors affecting definitions of and approaches to integrative medicine: A mixed methods study examining China's integrative medicine development. Evid Based Complement Alternat Med, 2015; 2015:1–12.
30.
BradleyR, Booth-LaForceC, HanesD, et al.Design of a multidisciplinary training program in complementary and integrative health clinical research: Building research across interdisciplinary gaps. J Altern Complement Med, 2019; 25:509–516.
31.
ChungVC, LawMP, WongSY, et al.Postgraduate education for Chinese medicine practitioners: A Hong Kong perspective. BMC Med Educ, 2009; 9:10.
32.
AhnAC, NahinRL, CalabreseC, et al.Applying principles from complex systems to studying the efficacy of CAM therapies. J Altern Complement Med, 2010; 16:1015–1022.
33.
ValentiniJ, KlockeC, GüthlinC, JoosS. Integration of complementary and integrative medicine competencies in general practice postgraduate education—Development of a novel competency catalogue in Germany. BMC Complement Med Ther, 2021; 21:250.
34.
KliglerB, BrooksAJ, MaizesV, et al.Interprofessional competencies in integrative primary healthcare. Glob Adv Health Med, 2015; 4:33–39.
35.
AmriH, HaramatiA. Using Basic Science to Develop an Innovative Program in Complementary and Alternative Medicine. J Int Assoc Med Sci Educ, 2010; 20(2):48–55.
36.
MaiersM, McKenzieE, EvansR, McKenzieM. The development of a prospective data collection process in a Traditional Chinese Medicine teaching clinic. J Altern Complement Med, 2009; 15:305–320.
37.
AndersonBJ, KliglerB, TaylorB, et al.Faculty survey to assess research literacy and evidence-informed practice interest and support at pacific college of oriental medicine. J Altern Complement Med, 2014; 20:705–712.
38.
ZhangK, TangQ. The dilemma and hope of Traditional Chinese Medicine practitioners in China. Integr Med Res, 2020; 9:100411.
39.
WaynePM, HammerschlagR, Savetsky-GermanJ, ChapmanTF. Attitudes and interests toward research among students at two colleges of acupuncture and oriental medicine. Explore, 2010; 6:22–28.
40.
AndersonBJ, KliglerBE, MarantzPR, et al.Developing, integrating, and implementing evidence-informed practice curricula throughout a Chinese medicine degree program. J Altern Complement Med, 2020; 26:463–472.
41.
LimMY, HuangJ, ZhaoB, HaL. Current status of acupuncture and moxibustion in China. Chin Med, 2015; 10:12.
42.
GivatiA, BerlinskyS. The ‘disenchantment’ of traditional acupuncturists in higher education. Health, 2023; 27:20–40.
43.
BarnesLL. The acupuncture wars: The professionalizing of American acupuncture-a view from Massachusetts. Med Anthropol, 2003; 22:261–301.
44.
ChangR.Chinese Medicine Masquerading As Yi: A Case of Chinese Self-Colonisation. Bretti, NSW, Australia: Maninriver Press; 2015.
45.
World Health Organization. Benchmarks for training in traditional/complementary and alternative medicine: Benchmarks for training in traditional Chinese medicine. 2010. Online document at: https://apps.who.int/iris/handle/10665/44353 Accessed November13, 2021.
