Complementary Medicines

limiting research in complementary medicine:

• Lack of funding—In 1995 only 0.08% of NHS research funds were spent on complementary medicine. Many funding bodies have been reluctant to give grants for research in complementary medicine Pharmaceutical companies have little commercial interest in researching complementary medicine
• Lack of research skills—Complementary practitioners usually have no training in critical evaluation of existing research or practical research skills
• Lack of an academic infrastructure—This means limited access tocomputer and library facilities, statistical support, academic supervision, and university research grants
• Insufficient patient numbers—Individual list sizes are small, and most practitioners have no disease “specialty” and therefore see very small numbers ofpatients with the same clinical condition Recruiting patients into studies is difficult in private practice
• Difficulty undertaking and interpreting systematic reviews—Manypoor quality studies make interpretation of results difficult. Many publications in complementary medicine are not on standard databases such as Medline. Many different types of treatment exist within each complementary discipline (for example, formula, individualised, electro, laser, and auricular acupuncture)
• Methodological issues—Responses to treatment are unpredictable and individual, and treatment is usually not standardised. Designing appropriate controlsfor some complementary therapies (such as acupuncture, manipulation) is difficult, as is blinding patients to treatment allocation.