2025 Conference

MEMBER SYMPOSIA #7-9

Saturday, April 5, 2025 (11am - 12:30pm)

Member Symposium #7: Real-World Evidence: Analyzing Pragmatic Data from Case Reports and Clinical Registries

Presenters: Kathleen Lumiere, DAOM, LAc; David Riley; Lisa Conboy, MA, MS, ScD; Lisa Taylor-Swanson; Beau Anderson, PhD, MA (Ed), LAc; Sandro Graca, MSc, Lic.TCM, FABORM; and Nick Lowe

This symposium bridges practitioners’ desire for research involvement and researchers’ need for clinically relevant trials. Our mixed-methods approach synthesizes pragmatic datasets to advance evidence-based practice and refine trial design. For a clinician, this talk offers means to potentially inform practice and track methods and outcomes for insurance compensation.     Attendees will gain tools to: capture qualitative patient experiences with quantitative measures enabling practice-based evidence and insurance compensation, identify patterns in TEAM data, and contribute to practice-based research.    Topics include quantitative and qualitative analysis, data standardization, identifying complex phenomena in TEAM, and practical methods for practitioners and researchers.    Topics:  Introduction and Overview (10 min)  - Importance of case reports  - Emergence of reporting guidelines  - Challenges/opportunities in analyzing pragmatic datasets  Mixed Methods (25 min)  Qualitative   Thematic analyses  Identifying themes in diagnoses and outcomes  Concurrent triangulation mixed methods design  Data integration and interpretation strategies  Quantitative  Descriptive statistics and responder analysis  Sensitivity analyses for subgroups  Data Standardization and Coding (10 min)  - ICPC-2 and ICD-11 TM codes   - Charting with quantitative scales, tracking adverse events  - Comparing case reports to routine clinical data  Future Directions (10 min)  - Practice-based research and clinical trial design  - Next steps in standardizing pragmatic data collection    Relevance to Conference Theme: This symposium directly aligns with the conference theme, showcasing novel methods for integrating diverse real-world TEAM data. Using case reports, clinical registries, and mixed-methods analyses, we demonstrate how researchers can gain insights into TEAM practices and outcomes, while guiding practitioners on clinic procedures to enable analyses.

As mentioned above, this symposium meets practitioners’ desire for research involvement and researchers’ need for clinically relevant trials. Our mixed-methods approach synthesizes pragmatic datasets to advance evidence-based practice and refine trial design. For a clinician, this talk offers means to potentially inform practice and track methods and outcomes for insurance compensation.

Member Symposium #8: Self-administered Acupressure: A Novel Promising mHealth Approach for Pain Management

Presenters: Richard E Harris, PhD; Suzanna Zick, ND, MPH; and Ying Wang, MD, PhD

A large body of evidence has shown the effectiveness and efficacy of acupuncture in relieving chronic pain. However, the accessibility of acupuncture providers and clinics can be limiting for individuals with  physical dysfunction, difficulties of accessing transportation, and also low income. Acupressure, is a technique derived from the same theoretical and practical traditional Chinese medicine framework of acupuncture, but instead of using needles, it involves applying mild physical pressure by fingers or a device to acupoints (i.e., the same body sites used for needle insertion in acupuncture treatments). Acupressure is also a novel telehealth approach that can be effectively self-administered by patients themselves with little to no side-effects in home-based settings. Thus, acupressure, if as effective, could provide significant advantages in accessibility and cost compared to acupuncture for individuals with chronic pain. The feasibility and efficacy of acupressure have been studied in several clinical pain populations, such as low back pain, cancer survivors, and osteoarthritis of the knee.  These studies have demonstrated positive impact in improving pain, fatigue, sleep, other symptoms and quality of life (QoL). In this panel, we have 3 speakers to discuss their ongoing clinical trials in evaluating the effectiveness of self-administered acupressure in pain and other clinical symptoms associated with chronic lower back pain (cLBP), ovarian cancer survivors, and sickle cell disease (SCD). Attendees of this symposium will obtain a comprehensive understanding of clinical effectiveness of self-administered acupressure in clinical pain populations.    Approximately 13% of adults in the United States experience chronic lower back pain, A wide array of evidence-based approaches are commonly used for the treatment of chronic low back pain (cLBP). Many individuals with chronic low back pain report a significant decrease in quality of life due to their pain. Yet, most studies show that only about one third of patients with cLBP benefit appreciably from any particular treatment. Dr. Harris will discuss the preliminary results of 303 patients with cLBP from an ongoing RCT “UM BACPAC SMART” study which aims to evaluate clinical effectiveness of acupressure as compared to 3 other interventions (mindfulness-based stress reduction, physical therapy, duloxetine) for individuals with cLBP.     Chronic pain is also a common issue among ovarian cancer survivors, affecting up to 50-60% of women. This persistent pain often results from a combination of surgical, chemotherapy, and radiation treatments, which can damage nerves and tissues. Pain can also be exacerbated by anxiety/depression and the stress of living with cancer, as well as the side effects like neuropathy, adhesions, and pelvic discomfort that persist beyond treatment, which significantly reduces the survivors’ QoL. Both acupuncture and acupressure have been found to improve pain in various cancer survivors none have focused on ovarian cancer despite this group having more pain than other cancer types. Dr. Zick from UM will talk about her ongoing sham-controlled RCT and its clinical efficacy of self-acupressure intervention on pain in 171 fatigued breast cancer survivors.    Sickle cell disease (SCD) is a common inherited blood disorder afflicting 1 in 500 Black/African Americans and pain associated with SCD is a lifelong complication. A majority of people with SCD suffer from chronic pain and recurrent episodes of acute pain namely vasoocclusive crisis that is unique to SCD, leading to frequent hospitalization, opioid addiction/tolerance, and poor quality of life. Due to barriers to accessing healthcare, many patients with SCD also manage their pain at home, making self-care options for pain highly relevant to this population. Developing safe, effective, and low-cost approaches to address this unmet need are urgently needed. Emerging studies and our preliminary data suggests that integrative treatments such as acupuncture may be effective at reducing pain in SCD. Dr. Wang from IU will discuss about her ongoing new RCT in assessing the clinical impact of self-administered acupressure on pain, co-morbidities and QoL in patients with SCD.

The proposed session will provide important research data freshly generated from 3 ongoing clinical trials investigating the clinical efficacy of acupressure for clinical pain management. These results have significant clinical impact to address the unmet need of many individuals with chronic pain.

Member Symposium #9: Data Informed Access and Equity Trends for Acupuncture at the Veteran’s Health Administration

Presenters: Juli Olson; Steph Gregory; and Claudia Voyles

As the largest healthcare system in the U.S. the Veteran’s Health Administration may be viewed as a model for the utilization of acupuncture on a large scale. In the development of the Whole Health System, data tracking mechanisms have been developed to track the utilization of acupuncture services. The VA uses both internal staff providers and non-VA community care providers to deliver acupuncture. Trending in on-station and non-VA delivery will be discussed. Practitioners who may be interested in caring for Veterans, an underserved population, will be provided with information about how to join the VA system as staff and non-VA community care providers.    Access to acupuncture services in the U.S. is uneven. This symposia will highlight how VA is adapting to provide the greatest amount of acupuncture services by utilizing licensed acupuncturists, those with acupuncture scope of practice (physicians, chiropractors) and protocolized auricular approaches. Data about trends in on-station and non-VA delivery through the Community Care Network will be covered.   We will discuss trends in acupuncture utilization by age, gender, other demographic information that provides a glimpse of acupuncture when access is more evenly distributed to all enrolled members. Veteran electronic health record data and survey information from over 6,400 Veteran respondents identified that 17% had used acupuncture. From these respondents, demographic information and diagnosed conditions will be shared.   Systems-based implementation lessons learned and implementation barriers will be discussed in how the VA is building a model of team-based care which includes acupuncture services. This will include discussion of policy and guidance for who may deliver acupuncture in the VA and community, indications for referral, team-based care principles and case management when part of the team is outside the VA system.   Challenges of delivering acupuncture to 9 million Veterans with a small but growing workforce will be shared. The VHA has endorsed two protocolized auricular acupuncture approaches to improve access and provide a significant amount of acupuncture. These two protocols are: the Battlefield Acupuncture Protocol and the NADA Protocol. Methods of training, scope of practice and the infrastructure to support these protocols will be presented. When sites do not have funding or ability to hire additional providers the use of protocolized approaches may be useful.

Unpublished data of trends in utilization and demographics of Veteran acupuncture services when access is available will be shared. Published Whole Health system research that supports inclusion of acupuncture services will be shared including research updates since this group last presented at the 2023 SAR conference.