Professor Debbie Sharp questions what needs to happen nationally to develop a proper evidence base for effective complementary therapies…
The fashion for delivering complementary therapies on the NHS has waxed and waned over many years, since well before the fashion for evidence-based medicine started to drive health policy.
And with the waxing and waning, the demand for complementary therapies has to a large extent been met in the private sector. Thus, access to complementary medicine has largely been the prerogative of the more well-off.
In order to rectify this imbalance of availability, we need to be able to provide health policymakers with the evidence for the effectiveness – and cost-effectiveness – for the complementary approaches that we believe will be of most use and interest to patients and health care professionals.
This evidence has to be produced by undertaking high quality research. By high quality, we mean asking the right research questions, designing studies with the methodology to answer those questions, undertaking robust analyses of the resulting data and being prepared to publish and share the results whatever they may show. However, to undertake the research, we need funders who are prepared to support us.
The financial problems being suffered by the NHS are also affecting many funding bodies making competition for research grants fiercer than ever and thus the probability of funding research into complementary therapies possibly even less likely.
But if we have research teams who can adhere to the quality criteria above and make the argument, that for many disorders currently costing the NHS vast amounts, for example mental health and musculoskeletal, an integrative approach might reduce the financial burden to the NHS, then we could be in business.
Essentially, we could offer a research agenda that has the support of commissioners and thus the potential to offer cost-effective alternatives to the status quo.
This agenda will take time, as at a national level we need to agree the research questions, ensure we have enough high quality researchers with an interest in this agenda and are prepared to train their younger colleagues in the methodological approaches that are needed.
The call to arms needs to go far and wide and capture the imagination of many different stakeholders – the Royal Colleges, the relevant charities and regulatory bodies, the CAM professional organisations, the academic departments and, of course, the funders. We all have a role to play.