Putting the research into practice
I am a great believer - as many of us are - in following the evidence. If there is good research evidence that an intervention or diagnostic tool works and it is available then we should consider using it. But the difficulty can be translating that research evidence into everyday practice.
An example of this stems from two pieces of research recently covered in the univadis GP News service. The first article (click here) reports: "Nurse-led group acupuncture clinics for patients with knee osteoarthritis offer a cost-effective alternative to surgery, say researchers." Following that article, another similar story appeared (click here), reporting that "referring patients with chronic or recurrent low back pain to attend specialist yoga classes would be a worthwhile use of NHS resources".
Both interventions are not standard, everyday mainstream therapies from a primary care perspective, but this kind of research should make us stop, think and reflect. They each offer a potential cost-effective treatment for chronic musculoskeletal conditions seen commonly in primary care. In addition, these two therapies offer an alternative to pharmacological treatment.
However, medicine is a conservative profession and some practitioners (as well as patients) may feel a little uncomfortable about using yoga and acupuncture as treatment. Of course before deploying these therapies, we will need more substantial proof of their effectiveness both in terms of clinical outcomes as well as financially.
Even if further substantial and overwhelming evidence is found in the future, the people holding the purse strings in the modern NHS will have to be persuaded to fund these interventions. If all these hurdles are overcome then they should be offered as frontline services, but even then it is not always the end of the story.
What happens in a research environment may not always satisfactorily or fully transfer to everyday practice. However that should not deter the researchers from continuing the flow of new knowledge and helping to improve the quality of the care that we provide to our patients.
Dr Harry Brown, editor-in-chief Univadis
By Dr Harry Brown