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The Consortium 12570 Turtle Creek Drive New Buffalo, MI 49117 [email protected] 269-264-9261 www.imconsortium.org

Membership Application

Application Process: To be considered for membership, the institution will need to submit an application that will consist of: • A written request of participation by the senior leadership (e.g. CEO, COO) of the given institution. • Supporting documentation, including a description of the organizational structure or working relationships of the institution's

integrative medicine/health program and its ongoing efforts in at least two of the following: research, education, and clinical care. Supporting documentation should also address the institution's commitment to this field and how the membership dues will be paid and sustained.

Choose one: Health System Academic Health Centeri

Name of Institution:

City, State:

Person preparing application:

Name:

Title:

Phone: Email:

Name of CEO/Dean supporting the application:

Steering Committee Member (may be the person completing the application or someone else:

Name: Email:

Alternate Steering Committee Member (may be the person completing the application or someone else:

Name: Email:

Person who handles dissemination of news about your institution’s activities and integrative medicine:

Name: Email:

Title or role (e.g., Director of Communications; Admin. Assist; Assistant Professor):

x

NICM Health Research Institute

Sydney, Australia

Dr Carolyn Ee

Senior Research Fellow

+61413319830 [email protected]

Professor Dennis Chang

Dr Carolyn Ee [email protected]

Professor Jerome Sarris [email protected]

[email protected] Natalie Connor

Senior Manager, Marketing and Communications

1 WESTERN SYDNEY UNIVERSITY AND NICM HEALTH RESEARCH INSTITUTE MEMBERSHIP APPLICATION

Application for Membership in the

Academic Consortium for Integrative Medicine and Health (ACIMH)

August, 2020


PART A: EXECUTIVE SUMMARY A World Leader in Complementary and Integrative Medicine Western Sydney University is a modern, forward-thinking, research-led university, located at the heart of Australia’s fastest growing and economically significant Western Sydney region. Boasting 10 campuses—many in CBD locations—and more than 170,000 alumni, 44,000 students and 3,000 staff, the University has 14 Schools with an array of well-designed programs and courses carefully structured to meet the demands of future industry. The University is ranked in the top two per cent of Universities worldwide and as a research leader, 85 per cent of the University’s assessed research is rated at ‘World Standard’ or above.

NICM Health Research Institute (NICM HRI) at Western Sydney University is one of the world’s largest integrative medicine research institutes. Seed funded by the Australian Federal Government and NSW State Governments in 2007, NICM HRI is now recognised as a world leader and Australia’s highest performing research institute in complementary medicine research, education and policy development. NICM HRI has been awarded the highest rating possible from the Australian Government, with research evaluated as performing “well above world standard” (ERA 5) under the Excellence in Research Australia scheme.1

NICM HRI is situated in the Westmead Medical Precinct, one of the largest medical precincts in Australia, which includes four hospitals, several research institutes and where over one million patient consultations occur each year. Based in a newly restored heritage building in Westmead, NICM HRI’s new state-of-the-art premises includes world-leading herbal pharmacology and chemistry research laboratories and an academic integrative medicine centre, due to open in late 2020.

NICM HRI has created a broad network of research partnerships with international organisations in government and industry, including a number of prestigious universities and hospitals in China, Australia, Asia, Europe and the United States. With a long history of proven research output, NICM HRI is now the strongest integrative medicine research institute in Australia with ‘bench to bedside’ capabilities, and one of the largest in the Western world. Western Sydney University remains one of the few universities in the West to deliver both complementary medicine and conventional medical education, creating a unique opportunity internationally to integrate the best of both.

NICM HRI is a financially secure and sustainable University research institute. It has received major endorsement and ongoing support from Western Sydney University,

1 Excellence in Research for Australia (ERA) is Australia’s national research evaluation framework. ERA identifies and promotes excellence across the full spectrum of research activity in Australia’s higher education institutions.


Government, and external industry stakeholders since its inception. University funds cover state-of-the-art facilities, professional services and operating costs as well as supporting core academic and professional staff. NICM HRI is also eligible for internal funding schemes including the Vice Chancellor’s Postdoctoral Fellowship scheme and the Research Infrastructure Capital Fund.

Our staff currently comprise 50 research and professional staff, 25 higher degree research students, 10 international visiting scholars per annum and 40 adjunct academic staff.

NICM HRI’s focus remains on personalised care and combining the best of conventional medicine and evidence-based complementary medicine. We have the premises, track record, leadership and the potential to remain a world leader in this important area. NICM HRI seeks to strengthen our research capacity, strengthen evidence based integrative health care services and ensure access for all Australians, no matter where they live, their background or education.


PART B: APPLICATION NARRATIVE 1. Summarize the institution’s activities in integrative medicine and health (IMH) at

the institution. This can be presented in any format, either in prose or outline form.

See executive summary above.

2. Names, titles and departments of additional institutional staff/faculty involved in

Integrative Medicine and Health at the institution, including the people identified to serve as the Steering Committee Member and the Alternate.

NICM HRI is led by Acting Director, Professor Dennis Chang. All of our researchers are involved in integrative medicine and health, and include:

• Professor Alan Bensoussan, outgoing Director • Professor Chun Guang Li, Professor of Pharmacology Research • Associate Professor Genevieve Steiner, Research Director • Dr Mike Armour, Postdoctoral Senior Research Fellow • Dr Guoyan (Emily) Yang, Postdoctoral Research Fellow (Tai Chi research) • Dr Michael de Manincor, Postdoctoral Research Fellow (Yoga research)

Our Steering Committee members are Professor Dennis Chang, Professor Jerome Sarris, Dr Carolyn Ee, and Dr Suzanne Grant.

1. Professor Dennis Chang, Acting Director Professor Chang is Acting Director of NICM, Professor of Pharmacology and the lead of NICM Health Research Institute's Healthy Hearts Research Program. His research interests include clinical and pharmacological studies of herbal medicine and other complementary medicine interventions at the Institute.

Professor Chang has led a number of significant clinical trials to evaluate the effect of herbal, yoga and tai chi for the treatment of dementia, mild cognitive impairment, coronary heart disease, metabolic syndrome and type 2 diabetes.

He has also led multiple laboratory-based pharmacological studies to evaluate pharmacokinetic/bioavailability profiles and mechanisms of action underlying the neuro and cardiac-protective effects of these medicines using a range of in vitro and in vivo models. Professor Chang's research has been published in a broad range of high-quality peer-reviewed journals such as Cochrane Systematic Review, Journal of Translational Medicine, Clinical Pharmacology and Therapeutics, and British Journal of Pharmacology. His research has attracted significant research funding support from various external funding agencies, governments and industry totalling over $6 million. As the Institute's


Associate Director International, Professor Chang also plays a leading role in the development of the Institute's international partnership program, which has led to substantial collaborations and partnerships with prestigious universities, research institutions and the pharmaceutical/herbal medicine industry.

2. Professor Jerome Sarris – Professor of Integrative Mental Health. Professor Sarris is Professor of Integrative Mental Health and leads the Healthy Minds Research Theme at NICM Health Research Institute. He holds an NHMRC Clinical Research Fellowship. He has a particular interest in anxiety and mood disorder research pertaining to nutraceutical psychopharmacology, in complementary and integrative medicine, lifestyle medicine, and psychotropic plant medicine research.

Professor Sarris has over 180 publications with an H-Index of 44 (cited over 7200 times), has published in various eminent psychiatry journals including The American Journal of Psychiatry, Lancet Psychiatry, JAMA Psychiatry, and World Psychiatry and has a combined Altmetrics score of greater than 9500.

He has been collaboratively awarded approximately $9.8 million dollars in personal and study grants, including being CIA on three recent multicentre NHMRC Project Grants.

Professor Sarris is a founding Vice Chair of The International Network of Integrative Mental Health and an Executive Committee Member of the International Society of Nutritional Psychiatric Research. He has been awarded the NHAA most notable contribution to herbal medicine research award, and the ANS Dr Tini Gruner Educator of the year in the field of Naturopathy.

3. Dr Carolyn Ee – Senior Research Fellow, Jacka Foundation Integrative

Medicine Program and Program Lead, Western Sydney Integrative Health.

Dr Ee is a GP and Senior Research Fellow at NICM Health Research Institute, Western Sydney University, and Program Lead of Western Sydney Integrative Health. She is Chair of the Royal Australian College of General Practitioners Integrative Medicine Specific Interest Network. Dr Ee is an Early Career Researcher (PhD conferred Mar 2017), has 29 peer-reviewed publications, and has been awarded $2.2 M of research funding as chief investigator. Dr Ee conducts rigorous mixed-methods research underpinned by co-design with consumers and translation into policy and practice, and is a rapidly emerging leader in integrative medicine research. Her research is underpinned by >20 years clinical experience in general practice. She has significant experience in randomised controlled trials. She is currently a CI/AI on 11 clinical trials, most of which are randomised double-blind placebo-controlled trials, including being CIA/CIB on six of those trials.


Relative to opportunity, which has included a high clinical and administrative load, Dr Ee’s work has had global reach and significance. Her PhD research on acupuncture for menopausal hot flushes was published in Annals of Internal Medicine and remains in the top 5% of Altmetrics research outputs, and was widely disseminated in international media and also reported in multiple medical resources and consumer publications such as Medscape, Up To Date reaching a broad range of clinicians and consumers globally. Dr Ee’s work is cited in clinical guidelines, including WHO guidelines on intrapartum care, and national Clinical Practice Guidelines Pregnancy Care. Dr Ee’s work on health services research has resulted in the establishment of Australia’s first academic integrative healthcare centre, scheduled to open in 2020, which will evaluate, for the first time, the real-world impact of an integrative collaborative care model in Australia.

4. Dr Suzanne Grant – Senior Research Fellow.

Dr Suzanne Grant is currently investigating options and outcomes in integrative healthcare. Her professional goal is to facilitate the pragmatic use of research to inform clinical practice and shape public health policy on traditional, complementary and integrative medicine. In clinical practice, she seeks to achieve the best individual patient health outcomes through ongoing development and the implementation of emerging evidence.

As a Senior Research Fellow, her research focus is on investigations and clinical trials that answer practical questions, including: Are patient outcomes improved with co-management by different provider types? What model of care best serves people with cancer? What is the best research design to understand the effectiveness of Chinese medicine in the treatment of people with cancer and other chronic diseases? What aspects of care matter most to patients? Information gained in these and other studies needs then to be translated into knowledge that improves patient care, policy guidelines, access and reimbursement.

Her research interests include the effect of Chinese herbal medicine and acupuncture in the treatment of chronic disease such as diabetes, and cancer. She is also interested in how Chinese medicine may help women with fertility problems. Dr Grant has been in private clinical practice as a Chinese herbalist and acupuncturist for over 10 years. She works within an integrative medicine centre with general practitioners, osteopaths, psychologists and a range of other therapists. Currently Dr Grant is the Senior Acupuncturist at the Chris O'Brien Lifehouse (formerly the Sydney Cancer Centre at Royal Prince Alfred Hospital). She specialises in helping cancer patients better cope with the side effects of chemotherapy, radiation and other treatments, and in helping cancer survivors bounce back faster.


3. Description of current activities of NICM Health Research Institute that focus on integrative medicine/health in at Clinical Care and Research:

NICM HRI was established to provide leadership and support for strategically directed research into complementary medicine and translation of evidence into clinical practice and relevant policy to benefit the health of all Australians. In 2020 NICM HRI will provide integrative medicine services to the community via the academic integrative health centre Western Sydney Integrative Health.

CLINICAL CARE

Western Sydney Integrative Health (WSIH) is Western Sydney University and NICM Health Research Institute’s flagship clinic in the burgeoning Westmead Health Precinct and the first academic integrative medicine centre in Australia. Due to open in late 2020, WSIH will integrate evidence-based complementary therapies with mainstream healthcare within a team-based and collaborative care setting and embedded within a research-based culture. Services include:

• Acupuncture • Chinese herbal medicine • Integrative medicine consultations with medical doctors • Nutritional support • Yoga therapy (group and individual) • Meditation and mindfulness • Tai chi • Music therapy • Oncology and remedial massage • Exercise physiology • Psychology

The WSIH model of care was co-designed with key stakeholders (end-users, GPs/family physicians and medical specialists). We aim to provide evidence-based care, guided by clinical pathways and evidence summaries, and will conduct Australia’s first integrative medicine patient registry. In 2018-9, we provided free acupuncture, oncology massage and yoga therapy to people with cancer in Western Sydney, funded by philanthropy.

As well as delivering direct health benefits for the community, Western Sydney Integrative Health is building strong research relationships with organisations including the Westmead Breast Cancer Institute, the Westmead Crown Princess Mary Cancer Centre, Specialist Services at Westmead Private, Westmead Women’s and Newborn Health, Western Sydney Diabetes, WentWest Primary Health Network, the Westmead Connectivity Centre, SydWest, and many other relevant health and community groups.


WSIH is anticipated to provide almost 30,000 consultations annually by Year 5 of operation.

RESEARCH

NICM HRI conducts research that advances our knowledge and understanding of natural and traditional medicine and promotes evidence-based integrative healthcare. Our research spans the bench to bedside continuum, including preclinical, clinical trials, and translational research.

Our research effort is concentrated in four clinical clusters:

• Healthy hearts: preventing and treating cardiovascular and metabolic disorders.

• Healthy minds: preventing and treating neurocognitive and mental health disorders.

• Healthy women: promoting sexual and reproductive health. • Healthy lives through cancer: staying healthy through the cancer journey.

NICM HRI also undertakes research in the following emerging areas:

• Traditional and indigenous medicine, such as bush medicine in Australia. • Mind and body therapies, such as yoga and meditation. • Medicinal cannabis.

NICM is celebrated as Australia’s premier integrative medicine research institute, offering the largest bench to bedside research concentration in the field in the West. We have been awarded the highest rating in the Excellence in Research Australia rankings for three consecutive cycles. Additional recognitions include:

• 2019: NICM staff comprise 3 of the top 10 most highly cited complementary medicine researchers in the world (Google Scholar); Dr Firth named as one of top five Australian rising stars for Health and Medical Sciences in The Australian’s Early Achievers Leaderboard Rising Stars Top 40; Professor Smith named as Australia’s Research Leader in Alternative and Traditional Medicine.

• 2018: World Federation of Chinese Medicine endorses NICM as International Centre for Chinese Medicine Clinical Research; Complementary Medicines Association – Research and Education Award in recognition of NICM’s research and impact; A/Prof Genevieve Steiner is awarded the prestigious Tall Poppy Award – government recognition/public; Emily Yang recipient of the Samueli Foundation Young Investigator Award

• 2017 Dr Carolyn Ee recipient of the Most Outstanding Junior Researcher – Clinical by the Society for Acupuncture Research


• 2013 Professor Bensoussan - prestigious International Award for Contribution to Chinese Medicine in Great Hall of the People.

• 1998 First high-quality clinical trial of Chinese medicine in the West published in the Journal of the American Medical Association.

Preclinical research

Our preclinical laboratory research focuses on the identification, bioactivity and mechanisms of action of herbal medicines and herb-drug interactions:

• Quality assurance through authentication of the botanical identity of raw herbs and identification of active ingredients.

• Extraction, isolation and quantification of herbal biomarkers. • Method development for quality assurance of complex herbal medicines and

stability studies herb-drug interactions. • Preclinical bioactivity and clinical availability studies. • Molecular basis of the neuroprotective and anti-ageing effects of traditional

Chinese herbal medicines.

Clinical research

NICM has particular strengths in conducting clinical trials in integrative medicine. NICM HRI's clinical research projects are undertaken in accordance with global standards of Good Clinical Practice using Standard Operating Procedures, and have been published in high-quality medical journals. NICM has successfully completed a substantial number of randomised controlled trials including on irritable bowel syndrome and infertility. Recently completed/current trials include:

• Chinese herbal medicine for vascular dementia • Chinese herbal medicine for mild cognitive impairment • Behind the brainwaves research study • NAC for Obsessive Compulsive Disorder • Antioxidants for sperm health • A topical herbal treatment for recurrent cold sores • Acupuncture for weight loss in polycystic ovary syndrome • Chinese herbal medicine for endometriosis • Herbal remedies for insomnia • Herbal medicine for the management of osteoarthritis of the knee • Yoga for depression and anxiety • Yoga and mental health in cancer • Acupuncture for cancer related fatigue

Our partnerships with other institutions as well as various specialist centres nationally and internationally has created a productive network of leading clinical experts and


facilities. NICM HRI's Clinical Research Laboratory facilitates a wide range of mechanistic studies on the effects of complementary medicine products (e.g., herbal formulae) and practices (e.g., acupuncture, yoga) on neurological and cardiovascular function. Key technologies include psychophysiological assessment, neuropsychological assessment, and cardiovascular assessment.

NICM researchers also have strengths in conducting meta-analyses on the efficacy of integrative therapies.

Translational research

NICM has demonstrated a strong commitment towards translation of our clinical evidence into policy and practice. NICM researchers are involved in clinical guideline development particularly in the areas of mental health and women’s health, and provide advice on regulation of complementary medicines through the Therapeutic Goods Administration. Our research is regularly cited in clinical guidelines. Professor Sarris currently co-chairs the Taskforce on Integrative and Complementary Medicine for the World Federation of Societies for Biological Psychiatry.

In developing the model of care for our academic integrative healthcare centre (WSIH), NICM researchers used Participatory Based Co-Design including focus groups with community members, semi-structured interviews with medical stakeholders, and establishing community reference groups and External Clinical Advisory groups. Our translational research on the WSIH model of care has been published in high-impact integrative and complementary journals, which are included below.

• Ee C, Templeman K, Grant S, Avard N, de Manincor M, Hunter J. Informing the model of care for an academic integrative healthcare centre: a qualitative study exploring healthcare consumer perspectives. BMC Complement Med Ther. 2020;20(1):58.

• Ee C, Templeman K, Grant S, Avard N, de Manincor M, Reath J, et al. Informing the Model of Care for an Academic Integrative Health Care Center: A Qualitative Study of Primary Care Stakeholder Views. J Altern Complement Med. 2020.

• Hunter J, Grant S, Ee C, Templeman K. What do medical specialists think about a proposed academic, integrative health centre in Australia? A qualitative study. Complementary Therapies in Medicine. 2020;53:102530.

NICM are establishing Australia’s first integrative medicine patient registry at WSIH, which will follow an estimated 10,000 patients over 10 years, link to health utilisation datasets, and evaluate the effectiveness of our model of care through tracking of health outcomes and quality of life through clinical data and PROMs/PREMs, and cost-effectiveness. Our patient registry is designed to benchmark against the PRIMIER registry in the USA.


EDUCATION

NICM recognises that integrative medicine has the potential to enhance primary care and should, therefore, be a routine part of mainstream general practice. Their broad-based scientific and generalist training as well as regular contact with the community mean that general practitioners (GPs) are ideally placed to assist patients in making choices in regards to CM/IM. Previous surveys of Australian GPs have found that many GPs incorporate aspects of IM, including prescribing or recommending CM, into their clinical practice. In addition, many of the surveys have identified an urgent need for education and high-quality information resources to be provided to assist GPs in their knowledge and understanding of CM, source clinical information from reliable sources, and to help facilitate sound communication with patients.

A significant driver for the incorporation of IM into general practice education has been the rising community interest in CM. The evidence demonstrates that the majority of patients in Australia regularly use, or have used, CM as well as conventional medicines and often do not discuss this with their GP. There are potential risks of side effects, interactions, and cumulative effects when conventional medicines and CM are taken together. Therefore, it is important for GPs to routinely ask patients about their use of CM, be aware of the growing scientific evidence and/or lack of evidence for these therapies, and have sound knowledge to provide patients with balanced information about potential benefits and risks in order to enable informed decision making.

The Royal Australian College of General Practitioners (RACGP) recognises the important need for ongoing education in the area of IM. This is reflected in the Integrative Medicine Statement in the RACGP Curriculum for Australian General Practice, in which IM has been identified as a specific content area. Support has been further demonstrated by the RACGP through the establishment of the IM Network within the Specific Interests Faculty, which Dr Ee has chaired for the past four years. Furthermore, the RACGP-Australasian Integrative Medicine Association (AIMA) Position Statement on Complementary Medicine, previously endorsed by the RACGP Council, emphasises the importance of GP training, continuing professional development, and standards for safe ethical practice in the area of IM.

Overall training, education and understanding of CM among Australian GPs, including efficacy and safety issues, remains poor and limited. There is a recognised need to develop high-quality training to further educate GPs on the efficacy and safety of CM, and to encourage ethical practice of IM to ensure that patients are provided with safe, evidence-based clinical practice. Little is known, however, in regards to what type(s) of education GPs need, their education and resource preferences, and practical delivery formats best suited to presenting such information.

Responding to this need, NICM undertook an extensive gap analysis of integrative medicine education in Australia in 2018-9, including a survey of 102 GPs and semi-


structured interviews with 15 GPs practising integrative medicine education. Findings from our research will be used to develop courses in integrative medicine which address the gaps in educating GPs and medical doctors on integrative medicine practice in Australia. These gaps include the medicolegal and ethical aspects of integrative medicine practice that are specific to an Australian context; interprofessional communication skills; and skills in evidence-based practice.

In addition to work on IM education offerings for GPs, NICM HRI researchers also teach within the School of Medicine and School of Health Science in the areas of integrative medicine, and regularly host research seminars featuring leading scientists such as Simon Rosenbaum and Karen Charlton.

c. NICM HRI’s commitment to the field of integrative medicine

NICM aims to continue to provide leadership within the field of integrative medicine in Australia and globally. Many of our researchers are senior leaders within integrative medicine with expertise ranging from bench to bedside research and translation and advocacy. We are a thriving research institute, and aim to continue to attract research funding for preclinical, clinical and translational research on the role of integrative therapies for the treatment and prevention of disease, particularly chronic disease.

We are establishing Australia’s first academic integrative healthcare centre which will integrate evidence-based integrative therapies with conventional healthcare, serving the Western Sydney community and beyond as a centre of excellence in integrative medicine. Our evidence-based and evidence-generating approach will significantly expand the body of evidence on the real-world impact of integrative therapies on health outcomes, quality of life and cost-effectiveness.

We are committed to training the next generation of integrative medicine physicians in Australia, through the development of co-designed integrative medicine education tailored specifically for medical doctors and meeting the needs of medical doctors in the Australian healthcare system.

Through our efforts in research, clinical care and education, we aim to contribute to the mission of the Academic Consortium for Integrative Medicine and Health to advance the principles and practices of integrative healthcare within academic institutions, and share in the collective voice for the advancement of academic integrative medicine globally. We look forward to representing the Asia Pacific region within the Consortium.

Francoise Adan Board of Directors Chair of the Academic Consortium of Integrative Medicine and Health [email protected]

Dale West Executive Director Academic Consortium for Integrative Medicine & Health Inc [email protected]

Dear Francoise and Dale,

I am very pleased to support NICM Health Research Institute’s application to the Academic Consortium for Integrative Medicine and Health.

Seed funded by the Australian and NSW Governments, NICM Health Research Institute at Western Sydney University has become one of the world’s largest integrative medicine research concentrations and Australia’s leader in complementary and integrative medicine research, education and policy development. Our multidisciplinary team is fully committed to preclinical, clinical and translational research on the role of integrative therapies for the treatment and prevention of disease, particularly chronic disease. Many of our researchers are senior leaders within integrative medicine with expertise ranging from bench to bedside research and research translation.

Our healthcare centre, which will be opened late this year will be the first academic integrative healthcare centre in Australia and aims to be a centre of excellence in integrative medicine. Our evidence-based and evidence-generating approach, which includes an integrative medicine patient registry, will significantly expand the body of evidence on the real-world impact of integrative therapies on health outcomes, quality of life and cost-effectiveness.

We are committed to training the next generation of integrative medicine physicians in Australia, through the development of co-designed integrative medicine education tailored specifically for medical doctors and meeting the needs of medical doctors in the Australian healthcare system.

We are very excited to have the opportunity to contribute to the mission of the Academic Consortium for Integrative Medicine and Health to advance the principles and practices of integrative healthcare within academic institutions, and share in the collective voice for the advancement of academic integrative medicine globally.

Sincerely

Professor Dennis Chang Acting Director

1 September 202 0

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