As part of its stepped-up effort to strengthen research in natural medicine, the National Institutes of Health is broadening eligibility for key financial awards that will hopefully draw experienced clinicians into the research enterprise.
According to Richard Nahin, PhD, a neuroscientist who is the senior advisor for scientific coordination and outreach at the NIH’s National Center for Complementary and Alternative Medicine (NCCAM), natural medicine research to date has been somewhat limited in value because many projects are designed and administered by conventionally trained practitioners with little experience of the holistic modalities they are studying.
Speaking at the annual meeting of the American Association of Naturopathic Physicians, Dr. Nahin said that often the people who are most knowledgeable about natural medicine lack clinical research experience. Others choose to dedicate themselves entirely to patient care.
He recognized that many clinicians, be they naturopaths, chiropractors, holistically-oriented MDs, acupuncturists, herbalists, or practitioners of various forms of traditional medicine, are struggling to make their livings and cannot afford the luxury of focusing on research projects.
K24 Awards, Loan Repayment Program
The NIH offers an award known as the “K24” that provides funding for mid-career faculty to take time off to mentor junior research fellows. Dr. Nahin stressed that while the vast majority of K24 recipients have been conventionally trained researchers, the program is open to licensed practitioners who are on faculty at training centers such as the naturopathic or chiropractic medical schools.
NCCAM also has an education loan repayment program for clinical researchers that supports qualified health care practitioners—including naturopaths, chiropractors and MDs or DOs—in exchange for 2 years of service on NIH-sponsored research projects. The loan repayment plan provides up to $35,000 per year to pay down debt incurred during medical education.
In the past, qualifications for the loan repayment program demanded at least a year of experience on an NCCAM funded project. But this will be changing. “The language stating that you have to have a year’s experience is going to be removed, which should open it to more naturopaths” and other holistic practitioners, Dr. Nahin said.
NCCAM’s budget, now exceeding $100 million, has seen a 10-fold increase since 1997 and a 50-fold rise since 1993 when the Office of Alternative Medicine—the seed for NCCAM—was established. The lion’s share of that money is going directly into research projects.
“For NIH as a whole, the portion of the total budget going to research is between 30% and 35%. For NCCAM, it has gone from 35% to around 70% of the total budget. We spend a larger percentage of our total budget on research than any other center within NIH,” said Dr. Nahin.
Clinically-Relevant Trials
NCCAM is almost exclusively dedicated to clinical trials. “We don’t do a lot of basic or pharmacokinetic research, and we bypass Phase I safety trials, given the long histories of safety (for modalities studied under NCCAM grants).” Dr. Nahin said NCCAM uses six criteria in identifying potential therapies for study: widespread use by the US public; credible preliminary data; public health significance; availability of research expertise; availability of a large pool of willing study subjects; and cost.
The Center is embarking on an ambitious study of Ginkgo biloba in prevention of dementia. The project will involve over 3,000 healthy individuals over age 75, randomized to placebo or Ginkgo (Schwabe’s standardized GB 461 product), 240 mg/d, and followed for 6 years to determine whether the herbal treatment has any measurable effect in preventing dementia or cognitive decline.
NCCAM is committing $23 million to the trial, and Dr. Nahin stressed this will be the largest natural products trial ever funded by a federal agency. It is also the largest primary prevention trial for dementia ever conducted. The last patients were enrolled in the study last May. NCCAM hopes to have the first reportable findings in 4 years.
Physicians interested in either the K24 grants or the loan repayment program should contact Dr. Nancy Pearson at 301-594-0519.
