News

Acupuncture wins BMA approval

Mark Silvert, BMJ

Acupuncture should become more widely available on the NHS and family doctors should be trained in some of its techniques, a BMA inquiry has concluded. The therapy has proved effective in treating back and dental pain, nausea and vomiting, and migraine, the BMA's Board of Science and Education has found after a two year study.

Acupuncture is one of the most frequently requested of the complementary therapies. Up to five million people may have consulted a therapist specialising in complementary or alternative medicine in the past year, the report says.

Welcoming the report, Dr Richard Halvorsen, a GP and press officer for the British Medical Acupuncture Society, said: "It indicates a complete change in the way that the medical establishment views complementary therapies." The study was commissioned in 1998 to "investigate the scientific basis and efficacy of acupuncture and the quality of training and standards of competence in its practitioners." It reviewed literature and current research on acupuncture and examined safety aspects, including adverse effects.

Complication rates associated with acupuncture are "relatively low," the study found. They generally fall into one of three categories: physical injuries, infections, and other adverse reactions. Many of the physical injuries could be avoided by ensuring that acupuncturists are fully trained in anatomy and physiology, with particular emphasis on teaching the location and depth of major organs. Inadequate or improper sterilisation techniques constitute a serious risk factor for infections, and this is recognised by professional acupuncture bodies and reflected in their codes of practice, states the report.

Transmission of infections can be avoided if all practitioners use only sterile disposable needles rather than reusable needles, which need sterilisation. Other adverse reactions include more minor events such as bleeding on withdrawal of the needle, bruising, and drowsiness. A survey of UK family doctors carried out as part of the study showed that nearly half had arranged acupuncture for patients and 58% had referred patients for some form of complementary or alternative medicine. The BMA is calling for a national register of all acupuncturists who are medically or non-medically qualified and for a national surveillance system to report adverse events.

Dr Vivian Nathanson, head of health policy at the BMA, said: "We need to see more high quality research into the effectiveness of acupuncture. Greater use of acupuncture would save the NHS millions of pounds each year." However, she added that a consensus needed to be built on the minimum standards of training required for all potential acupuncture practitioners.

The BMA hopes that the National Institute for Clinical Excellence will consider the value of acupuncture as a next step and produce guidance for the NHS.

Acupuncture: Efficacy, Safety, and Practice can be seen at the BMA's website (www.bma.org.uk).