Intended for healthcare professionals

Rapid response to:

Primary Care

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial

BMJ 2004; 328 doi: (Published 25 March 2004) Cite this as: BMJ 2004;328:744

Rapid Response:

Re: Would this trial design be acceptable for a medicine?


I think the design creates an excellent concept for trialling drugs
'in the market place' after the round of various trial phases is complete
- toxicology, RCT etc. and have found a drug safe and effective.

Unlike all modern drugs, acupuncture has been shown to be safe and
effective over millennia so drugs require different protocols at first to
ensure safety - bearing in mind that they are largely resposnible for
modern medicines position as the 3rd or 4th biggest killer and maimer of
mankind - so great caution must be taken before unleashing any into the
public arena.

Once they become accepted for public consumption, the various drugs
could be trialled for efficacy and effectiveness against acupuncture, and
other modalities, as per the Vickers et al concept - pragmatically.

Trialling drugs as acupuncture was trialled in this study -where the
prescription was left to the style, experience and discretion of the
practitioner - we should soon begin to see the realty of primary care
prescribing; it could also reveal trends in prescribing, costs, patient
satsifaction, and many other outcomes and variables in drug prescribing
etc. the like of which we rarely, if ever, realise from current drugs
research methodology.

I'm not sure how popular this would be with pharmaceutical companies
but I think it would be in the public interest.


John H.

Competing interests:
None declared

Competing interests: No competing interests

04 April 2004
John P Heptonstall
Director of The Morley Acupuncture Clinic and Complementary Therapy Centre
Leeds LS27 8EG