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					   Homeopathic
Community Research
              with

Todd Rowe, MD, MD(H), CCH, DHt and
      Iris Bell, MD, MD(H), PhD
We have fallen into a place
 where everything is music.
             -Rumi
Types of Homeopathic Research
•   1.   Basic Science
•   2.   Clinical Science
•   3.   Homeopathic Science (eg. Provings)
•   4.   Community Science
•   5.   Educational Science
(Jonas, Western J Med 2001)
Purpose of Community Research
• Helps us to better understand the homeopathic
  community including:
  – Demographics
  – Success Rates
  – Cost Effectiveness of Treatment
  – Reasons for seeking treatment
  – Reasons for choosing a practitioner
  – Effectiveness of various styles and types of
    homeopathic practice
    AMCH Community Research
• Homeopathic Practitioner Survey
  – Completed 2006
  – Complete results available at www.AMCofHorg
  – 1150 participants
• Homeopathic Patient Survey
  – Completed 2007
  – Complete results will be available at www.AMCofH.org on
    5/08
  – 1150 participants
• Homeopathic Educational Survey
  – Students, teachers, administrators
  – Will be completed by 2009
  – Contact info@AMCofH.org for survey links
Dispelling Myths About Homeopathic Practice
• Myth #1. Homeopathic treatment results are due
  to the effects of placebo.
• Myth #2: Homeopaths treat mostly functional or
  psychiatric conditions.
• Myth #3: There are a sufficient number of
  homeopathic practitioners in the United States.
• Myth #4: Homeopathic patients reflect the typical
  diversity of the US population.
• Myth #5: Success rates are the same for all
  homeopathic conditions.
• Myth #6: Children have better success rates than
  adults.
Dispelling Myths About Homeopathic Practice

• Myth #7: Elderly patients have worse success rates than
  adults.
• Myth #8: Homeopathic treatment is too expensive.
• Myth #9: Homeopathic treatment is equally effective
  regardless of modality of treatment.
• Myth #10: What patients like least about treatment is the
  lack of treatment success.
• Myth #11: It takes a long time to achieve success in
  homeopathic treatment.
• Myth #12: Side effects to homeopathic treatment where
  new symptoms develop (not return of old symptoms) are
  seldom seen in treatment.
Dispelling Myths About Homeopathic Practice

• Myth #13: It is impossible to make a living practicing
  homeopathic medicine.
• Myth #14: The homeopathic system of treatment makes a
  significant difference in treatment results.
• Myth #15: Understanding how homeopathic medicine
  works has no impact on treatment results.
• Myth #16: Those patients who are sensitive to conventional
  medications or to homeopathic medicines have poorer
  treatment results.
• Myth #17: Men do equally well in homeopathic treatment as
  do women.
Myth #1: Homeopathic Treatment Results are Due to
               the Effects of Placebo
• Placebo response rate is generally around
  30-40%
• General response rate to homeopathic
  treatment was 79%
• There was a lack of significant correlation
  between length of time in treatment to results
  (r=0.007 with a p value of 0.862, i.e., not at all
  significant). Placebo effects tend to occur early
  in treatment and then taper off over time - in
  people.
Myth #1: Homeopathic Treatment Results are Due to
                 the Effects of Placebo
• Success Rates (%)
  Myth #2: Homeopaths Treat Mostly Functional or
              Psychiatric Conditions

• This study indicates that homeopathy treats a
  wide variety of conditions successfully from mild
  to severe pathology with good results.
    Myth #2: Homeopaths Treat Mostly Functional or
                       Psychiatric Conditions
•   Total Respondents (%)
         Myth #3: There are sufficient numbers of
             homeopathic practitioners in the US.
• Levels of Practice (Practitioner Survey)
   – Level One: Appreciator
   – Level Two: Experimenter
   – Level Three: Acute Prescriber
   – Level Four: Integrative Prescriber
   – Level Five: Homeopathic Practitioner
• A Primary Complaint of Patients About Homeopathic Practice (Patient
  Survey)
    – Long Distance to Travel to Practitioner
    – Difficulty Locating a Practitioner
• Paucity vs. Density of Practitioners in Certain States
  National Homeopathic Practitioner Survey
Practitioner   Level Five   Level Four   Level Three   Level Two   Level One

MD, DO         400          700          1000          2500        7000


ND             150          1000         2000          5000        10,000

Nurses         500          1000         3000          18,000      70,000

DC             50           200          5000          10,000      25,000

LAc, OMD       50           225          500           1000        5000


DVM            50           250          1000          2000        4000

Unlicensed     1000         3000         20,000        250,000     12,000,000


Total          2200         6350         32,500        288,000     12,120,000
National Homeopathic Practitioner Survey
 National Homeopathic Practitioner Survey:
What Patients Like Least About Treatment (%)
   National Homeopathic Practitioner Survey: Relative
   Distribution of Homeopathic Practitioners per Capita
AZ: +3.45
CO: +4.0
KS: -4.65
Missouri: -9.8
SC: 4 -3.6
VT: +4.3
     U.S. National Surveys – Homeopathy
                     Use
• Eisenberg et al 1993 telephone survey (N=1539)
   – Homeopathy used by 1% of population, 32% provider-
     based, average of 6 visits/year
   – 24.7% partial insurance coverage for homeopathy
• Eisenberg et al. 1997 telephone survey (N=2055)
   – Homeopathy used by 3.4% of population, average of 1.6
     visits/year
   – 0% insurance coverage for homeopathy

•   Eisenberg D et al. Unconventional medicine in the United States. Prevalence, costs, and patterns of use.
    New Engl J Med 1993 Jan 28;328(4):246-52.
•   Eisenberg D et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-
    up national survey. JAMA. 1998 Nov 11;280(18):1569-75.
•   Tindle HA et al. Trends in use of complementary and alternative medicine by US adults: 1997-2002.
    Altern Ther Health Med. 2005 Jan-Feb;11(1):42-9.
 Myth #4: Homeopathic patients reflect the typical
          diversity of the US population.
• We found that there were many populations
  that were underserved by homeopathic
  medicine. These included:
  – Low income populations
  – Hispanic community
  – African American community
  – Natïve American community
  – Elderly
  Myth #4: Homeopathic patients reflect the typical
           diversity of the US population.
• National Homeopathic Patient Survey
      Myth #5: Success rates are the same for all
               homeopathic conditions.
• National Homeopathic Patient Survey
• We found that certain conditions had better success rates and
  other conditions had worse success rates.
• Infectious disease conditions had the highest success rates.
• Endocrinological conditions had the lowest overall success
  rates (p=.064), although there were no statistical differences in
  the other categories that we measured.
     Myth #5: Success rates are the same for all
              homeopathic conditions.
• National Homeopathic Patient Survey
         Cross-Sectional Observational
         Study – Homeopathy in General
                   Practice

• Van Wassenhoven M, Ives G. An observational study of
  patients receiving homeopathic treatment. Homeopathy.
  2004 Jan;93(1):3-11.
•   RESULTS: A total of 782 patients presented with diseases of all major organ systems which were of
    sufficient severity to interfere with daily living in 78% of cases. Compared to previous conventional
    treatment, patients reported that consultations were much longer but costed less. One or more
    conventional drug treatments were discontinued in over half (52%) of the patients: CNS (including
    psychotropic) drugs (21%), drugs for respiratory conditions (16%) and antibiotics (16%).

• The great majority (89%) said that homeopathy had
  improved their physical condition; 8.5% said that it had
  made no difference, 2.4% said that homeopathy had
  worsened their condition.
      Chronic Disease and CAM Use
• Saydah SH, Eberhardt MS. Use of complementary and
  alternative medicine among adults with chronic
  diseases: United States 2002. J Altern Complement Med.
  2006 Oct;12(8):805-12.
•   BACKGROUND: Use of Complementary and Alternative Medicine (CAM) has increased in
    recent years. OBJECTIVE: The aim of this study was to determine the use of CAM among
    people with diagnosed chronic diseases. DESIGN: Cross-sectional analysis was used.
    SETTING: The 2002 National Health Interview Survey was the setting. PATIENTS:
    Participants were representative of the noninstitutionalized U.S. population 18 years and
    older. MEASUREMENTS: Respondents answered questions about use of CAM and
    physician-diagnosed arthritis, cancer, cardiovascular disease, diabetes, and lung disease.
•   RESULTS: Adults with diagnosed chronic diseases are more likely to use CAM compared
    to adults with none of the reported chronic diseases. Adults with arthritis alone were
    most likely to report ever use of CAM (59.6%) followed by adults with cancer or lung
    disease alone or two or more chronic diseases (55%), adults with
    cardiovascular disease (46.4%), and adults with no chronic diseases (43.6%) and diabetes
    alone (41.4%). Adults with chronic diseases were also more likely to report use of CAM in
    the past 12 months (32% to 43.3%), followed by adults with none of these chronic
    diseases (32%), and adults with diabetes alone (26.2%).
  Myth #6: Children have better success rates than
                      adults.
• National Homeopathic Patient Survey
• We found that children had worse success rates than adults in
  all categories.
  Myth #6: Children have better success rates than
                      adults.
• National Homeopathic Patient Survey
   – Blue=Success Rates for Adults (%)
   – Red= Success Rates for Children (%)
   Myth #7: Elderly have worse success rates than
                       adults.
• National Homeopathic Patient Survey
• We found that the elderly had a trend towards slightly worse
  success rates.
   Myth #7: Elderly have worse success rates than
                       adults.
• National Homeopathic Patient Survey
• Blue=Adult Success Rates (%)
• Red=Elderly Success Rates (%)
 Myth #8: Homeopathic treatment is too expensive.
• National Homeopathic Patient Survey
• This was a major complaint of homeopathic patients in the
  survey.
• However the average cost of homeopathic treatment annually
  was only $580.78 per year.
• The average cost savings of the reduction in conventional
  medication and supplements was $1033.20 per year.
• This makes for a net cost savings of $452.42 per year.
 Myth #8: Homeopathic treatment is too expensive.
• National Homeopathic Patient Survey (What patients like least
  about treatment [%])
 Myth #8: Homeopathic treatment is too expensive.
• National Homeopathic Patient Survey (Average cost for
  treatment in US Dollars)
 Myth #8: Homeopathic treatment is too expensive.
• National Homeopathic Patient Survey (Average cost for
  homeopathic medication in US Dollars)
 Myth #8: Homeopathic treatment is too expensive.
• National Homeopathic Patient Survey (Average cost savings
  from reduction in conventional medication in US Dollars)
           Cross-Sectional Observational
           Study – Homeopathy in General
                     Practice
•   Van Wassenhoven M, Ives G. An observational study of patients receiving
    homeopathic treatment. Homeopathy. 2004 Jan;93(1):3-11.
•   BACKGROUND: Observational studies have recently contributed useful information to the debate about
    the utility of homeopathic treatment in everyday practice. AIM: To gather data about routine homeopathic
    general practice. SETTING: Eighty general medical practices in Belgium where physicians were members
    of the Unio Homoeopathica Belgica. METHODS: All patients and their physicians visiting the practices on
    a specified day completed a questionnaire. RESULTS: A total of 782 patients presented with diseases
    of all major organ systems which were of sufficient severity to interfere with daily living in 78% of cases.
    Compared to previous conventional treatment, patients reported that consultations were much longer but
    costed less. One or more conventional drug treatments were discontinued in over half (52%) of the
    patients: CNS (including psychotropic) drugs (21%), drugs for respiratory conditions (16%) and antibiotics
    (16%). Conventional drugs were prescribed to about a quarter of patients (27%), mostly antibiotics and
    cardiovascular medication. The antibiotics were almost exclusively (95%) used to treat respiratory
    infections.

• Prescription costs (including conventional medicines)
  were one-third of the general practice average.
    Myth #9: Homeopathic treatment is equally effective for
              regardless of the modality of treatment.
• National Homeopathic Patient Survey
                                        .
• We found in this study that patient reported success for classical
  homeopathy was statistically higher in all categories than for complex
  homeopathic treatment [overall success (p=.002); chief complaint (p=.001);
  Mental/emotional improvement (p=.006); Physical improvement (p=.0009);
  Well being improvement (.002); Improvement in energy (p=.009);
  Improvement in awareness (p=.009).
• We found that there were no statistically significant differences between
  classical homeopathic treatment and combined classical and complex
  homeopathic treatment.
    Myth #9: Homeopathic treatment is equally effective
           regardless of the modality of treatment.
• National Homeopathic Patient .
                               Survey
• Success Rates by Type of Homeopathic Treatment (%)
 Myth #10: What patients like least about treatment is the lack
                     of treatment success.
• National Homeopathic Patient .  Survey
• This was not found to be true. The strongest response to the
  question of what patients liked least about homeopathic
  treatment was the slow pace of healing.
 Myth #10: What patients like least about treatment is the lack
                    of treatment success.
• National Homeopathic Patient .Survey (%)
    Myth #11: It takes a long time to achieve “success” in
                    homeopathic treatment.
• National Homeopathic Patient . Survey
• We found that this was not true.
   Myth #11: It takes a long time to achieve “success” in
                   homeopathic treatment.
• National Homeopathic Patient .
                               Survey (months).
 Myth #12: Side effects to homeopathic treatment where new symptoms
  develop (not return of old symptoms) are seldom seen in treatment.

• National Homeopathic Patient .
                               Survey (%)
 Myth #12: Side effects to homeopathic treatment where new symptoms
  develop (not return of old symptoms) are seldom seen in treatment.

• National Homeopathic Patient .
                               Survey (%)
• How much of a problem have side effects been in treatment?
 Myth #12: Side effects to homeopathic treatment where new
 symptoms develop (not return of old symptoms) are seldom
                      seen in treatment.
• National Homeopathic Patient .
                               Survey (%)
•   If you had a problem with side effects or aggravations, were the symptoms
    ones that you had previously experiences at some point earlier in your life or
    were they new symptoms for you?
       Observational Study – Homeopathy
                     Acutes

•   Haidvogl M, Riley DS, Heger M, Brien S, Jong M, Fischer M, Lewith GT, Jansen
    G, Thurneysen AE. Homeopathic and conventional treatment for acute
    respiratory and ear complaints: a comparative study on outcome in the
    primary care setting. BMC Complement Altern Med. 2007 Mar 2;7:7.
•   The primary outcome criterion was the response rate after 14 days of therapy. RESULTS: Data of 1,577 patients were
    evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of
    patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H:
    86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were
    obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response
    rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the
    primary outcome criterion was 1.40 (0.89-2.22) in children and 0.92 (0.63-1.34) in adults. Adjustments for demographic
    differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant
    differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was
    significantly faster upon homeopathic treatment both in children (p = 0.0488) and adults (p = 0.0001).

•   Adverse drug reactions occurred more frequently in adults of the conventional
    group than in the homeopathic group (C: 7.6%; H: 3.1%, p = 0.0032), whereas in
    children the occurrence of adverse drug reactions was not significantly
    different (H: 2.0%; C: 2.4%, p = 0.7838).
     Myth #13: It is impossible to make a living practicing
                     homeopathic medicine.
                                     .
• National Homeopathic Practitioner Survey (%)
• The overall average income of homeopathic practitioners was $4500.80 per
  month. This translates into a yearly income of $49,508.80 (11 months). For
  level five practitioners, the overall average annual income was $101,306.04.
     Myth #13: It is impossible to make a living practicing
                     homeopathic medicine.
                                     .
• National Homeopathic Practitioner Survey (%)
   Myth #14: The homeopathic system of treatment makes a
          significant difference in treatment results.
                                       .
• National Homeopathic Patient Survey (%)
• We had limited data to study this question. However, we did find that those
  patients who were treated with polycrest remedies achieved the same
  results as those who were treated with more esoteric remedies.
 Myth #15: Understanding how homeopathic medicine works
                 has no impact on treatment results.
• National Homeopathic Patient Survey (%)
                                     .
• We found that those patients who described better understanding of
  homeopathic treatment had statistically significantly better treatment results.
    Myth #15: Understanding how homeopathic medicine works
                   has no impact on treatment results.
•    National Homeopathic Patient Survey   .
•    Success Rates (%)
  Openness Personality Trait Predicts
Complementary & Alternative Medicine
Use (N=3,032) (Honda & Jacobson Prev Med 40(1):46-
                         53 2005)
                  Alternative Energy         Any CAM
                  Medical     Therapies
                  Systems
Agreeableness     1.69        2.41           1.06
Neuroticism       1.30        0.79           0.88
Openness          3.55 (1.33- 15.77 (2.86-   1.65 (1.18-
                  9.44)*      86.87)**       2.31)**
Extraversion      0.85        0.96           0.65 (0.46-
                                             0.91)*
Conscientiousness 0.90        1.64           0.94
    Myth #16: Those patients who are sensitive to conventional
      medications or to homeopathic medicines have poorer
                                    treatment results.
•    National Homeopathic Patient Survey          .
•    The study showed that there is a slight improvement in results for those patients who are more
     sensitive to either conventional medications or homeopathic medications.
    Myth #16: Those patients who are sensitive to conventional
     medications or to homeopathic medicines have poorer
                                  treatment results.
•    National Homeopathic Patient Survey   .
•    Success Rates (%)
Myth #17: Men do equally well in homeopathic treatment than
                          do women.
                               .
• National Homeopathic Patient Survey
• We found that women did consistently better in homeopathic
  treatment than did males.
.
    Demographics of Higher % CAM
    Users: 62% of 31, 044 interviews
           (Barnes et al Adv Data. 2004 May
                  27;(343):1-192004)
•   Age                                        Older
•   Gender                                     69.3% female
•   Education                                  College and above
•   Socioeconomic Status                       Higher
•   Region of U.S.                             Western states
See also : Ni H, Simile C, Hardy AM. Utilization of complementary and alternative
   medicine by United States adults: results from the 1999 national health
   interview survey. Med Care. 2002 Apr;40(4):353-8
    Myth #18: The main reason that people choose homeopathic
    treatment is that they are choosing homeopathic treatment
                    over conventional therapies.
                                   .
• National Homeopathic Patient Survey
•    CAM Research
      Predictors of CAM Use
(Astin JAMA 279(19):1548-53, 1998)
        (N=1035, random mail survey)
     more education
     poorer health status
     holistic orientation to health
     transformational experience
     certain health problems
       anxiety
       back problems
       chronic pain
       urinary tract problems

     certain cultural groups
Perceived Benefits from CAM Use
            (Astin JAMA 1998)
 “I get relief for my symptoms, the pain or
  discomfort is less or goes away. I feel
  better.” (perceived efficacy)
 “The treatment works better for my
  particular health problem than standard
  medicine’s.” (perceived efficacy)
 “The treatment promotes health rather
  than just focusing on illness.”
  (philosophical congruence)
      Parameters that Effect Results
Parameter                                Result
Sex                                      Women get better results then men

Age                                      Younger patients do not respond as well to treatment; elderly
                                         patients show an average response

Species                                  Animals show the same response rate as humans

Marital Status                           Married Patients Get Better Results

Educational Level                        Average Response Rate

Sensitivity to Conventional Medication   Slightly Improved Response Rate

Sensitivity to Homeopathic Medication    Slightly Improved Response Rate

Classical Homeopathy                     Average Response Rate

Complex Homeopathy                       Slightly Reduced Response Rate

Combined Classical and Complex           Average Response Rate

Long Length of Treatment                 Slightly Improved Response Rate

Frequent Visits to Practitioner          Average Response Rate

Past Treatment Responders                Slightly Improved Response Rate

Past Treatment Failures                  Average Response Rate
     Parameters that Effect Results
Parameter                                     Result
Endocrinology chief complaint                 Reduced response rate

Gynecology, Immunology, Infectious Disease,   Improved Response Rate
chief complaint


Polycrest Prescriptions                       Average Response Rate

Frequent Antidoting                           Reduced Response Rate

Strong Side Effects                           Reduced Response Rate

Low Compliance With Treatment                 Reduced Response Rate

Understanding How Homeopathy Works            Improved Response Rate

Cardiology, Dermatology, Gastrointestinal,    Average Response Rate
Musculoskeletal, Neurological, Psychiatric,
Pulmonary chief complaint



High Cost                                     Reduced Response Rate
 Comparison of Homeopathic and Conventional Medicine As
                  Perceived by Patients
Description           Homeopathic Medicine   Conventional Medicine


Cost (Treatment)      Less Expensive         More expensive

Cost (Medication)     Less Expensive         More Expensive

Efficacy              More Effective         Less Effective

Direction of Cure     Holistic               Suppressive

Nature of Treatment   Natural                Artificial


Style of Treatment    Simple                 Complex

Practitioner          Caring and Trust       Not Heard
Communication
Focus of Treatment    Wellness Focused       Disease Focused
Relationship with     Empowered              Dependent
Practitioner
Self Treatment        Yes                    No

Philosophy            Yes                    No
  Comparison of Homeopathic and Conventional Medicine As
                   Perceived by Patients
Description                  Homeopathic Medicine   Conventional Medicine

Safety                       Gentle                 Harsh

Effects of Treatment         Deep                   Superficial

Availability of              Poor                   Good
Practitioners

Difficulty to Practice       Harder                 Easier

Patient Understanding of     Harder                 Easier
Treatment

Compliance                   Better                 Worse
Interview                    Time Intensive         Brief
Focus of Interview           Totality Focused       Diagnostic Focus

Patient Loyalty              Higher                 Lower

Patient Sensitivity          Higher                 Lower
Formulary                    Larger                 Smaller
Payment for Tx               Out of Pocket          Insurance
Patient Level of Education   Higher                 Lower
  Comparison of Homeopathic and Conventional Medicine As
                   Perceived by Patients
Description                 Homeopathic Medicine   Conventional Medicine

Sex                         More Women             More Even Distribution

Ethnicity                   More Caucasian         More Even Distribution

Ages                        All                    All

Other Patient Populations   Animals and Plants     Animals
              Caveats on Data (Bias)
•   1. Volunteer Patients
•   2. Comfort level with on-line communications
    and technology
•   3. Methods of reaching patients
•   4. Memory based data
•   5. Heterogeneity of subject popuation
•   6. Sample size
•   7. Confusion of terms (eg. “success”)
 Limitations of Survey Data
• Recruitment bias
  – People with telephones
  – People with computers
  – People with homes
• Retrospective recall in cross-sectional
  designs
  – Faulty memory
  – Causal attribution of response less clear
• Susceptible to phrasing of question (cf.
     Recommendations and Future Directions
•   1. The homeopathic community needs to train
    more homeopathic practitioners.
•   2. The homeopathic community needs to reach
    out to more diverse ethnic groups for treatment.
•   3. The homeopathic community needs to find
    better ways of reaching men in homeopathic
    treatment.
•   4. Further research needs to be done on
    comparing the efficacy of complex vs. classical
    homeopathic treatments.
   Recommendations and Future Directions
• 5. Further research needs to be done
  comparing the results of this survey to other
  alternative medicine fields within the United
  States.
• 6. Further research needs to be done
  comparing the results of this survey to
  international homeopathic studies.
• 7. Further research needs to be done
  comparing the efficacy of hahnemannian
  methods vs. more modern methods of
  prescribing.
   Recommendations and Future Directions
• 8. The homeopathic community should seek out
  methods to improve affordability for its patients.
• 9. Research needs to be done on reevaluating the
  potential for homeopathic treatment to cause side
  effects (other than a return of old symptoms).
• 10. The homeopathic community needs to do a better
  job in educating its patients about how homeopathic
  medicine works.
• 11. The homeopathic community should develop
  better marketing strategies that reflect the needs of
  their patients.
   Recommendations and Future Directions
• 12. The homeopathic community needs to find way to
  attract younger practitioners into the profession.
• 13. The homeopathic community needs to find ways
  to attract more men to the field.
• 14. The homeopathic community needs to find ways
  to attract more ethnically diverse practitioners,
  especially African Americans and Hispanics.
• 15. The homeopathic community needs to do a better
  job at attracting homeopathic practitioners as their
  first career.
   Recommendations and Future Directions
• 16. The homeopathic community needs to find ways to
  increase the length of veterinary homeopathic education.
• 17. The homeopathic community needs to find ways to attract
  DC’s and PA’s to the homeopathic profession.
• 18. The homeopathic community needs to charge more for
  homeopathic services.
• 19. The homeopathic community needs to find ways to make
  the homeopathic profession more lucrative for its membership.
• 20. Better define success in treatment in future surveys.
• 21. These surveys should be repeated every 7 years.
• 22. Standardize case taking and case follow up data collection
  with appropriate questionnaires.
    Observational Study – GP Homeopathy
                  Outcomes
•   Güthlin C, Lange O, Walach H. Measuring the effects of acupuncture and
    homoeopathy in general practice: an uncontrolled prospective documentation
    approach. BMC Public Health. 2004 Mar 4;4:6.
•   BACKGROUND: Despite the increasing demand for acupuncture and homoeopathy in
    Germany, little is known about the effects of these treatments in routine care. We set up a
    pragmatic documentation study in general practice funded within the scope of project launched
    by a German health insurer. Patients were followed-up for up to four years. METHODS: The
    aim of the project was to study the effects and benefits of acupuncture and/or homoeopathy,
    and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture
    and over 900 homoeopathy patients. As data sources, we used the documentation made
    available by therapists on every individual visit and a standardised quality-of-life questionnaire
    (MOS SF-36); these were complemented by questions concerning the patient's medical history
    and by questions on patient satisfaction. The health insurer provided us with data on work
    absenteeism.
•   RESULTS: Descriptive analyses of the main outcomes showed benefit of treatment with middle
    to large-sized effects for the quality of life questionnaire SF-36 and about 1 point improvement
    on a rating scale of effects, given by doctors. Data on the treatment and the patients' and
    physicians' background suggests chronically ill patients treated by fairly regular schemes.
•   CONCLUSION: Since the results showed evidence of a subjective benefit for patients from
    acupuncture and homoeopathy, this may account for the increase in demand for these
    treatments especially when patients are chronically ill and unsatisfied with the conventional
    treatment given previously.
    Observational Study – Homeopathy &
             Chronic Diseases
•   Witt CM, Lüdtke R, Baur R, Willich SN. Homeopathic medical practice: long-
    term results of a cohort study with 3981 patients. BMC Public Health. 2005 Nov
    3;5:115. Links

•   BACKGROUND: On the range of diagnoses, course of treatment, and long-term outcome in patients who
    chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in
    an industrialized country under everyday conditions. METHODS: In a prospective, multicentre
    cohort study with 103 primary care practices with additional specialisation in homeopathy in
    Germany and Switzerland, data from all patients (age > 1 year) consulting the physician for the first time were
    observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from
    0 to 10) and quality of life at baseline, and after 3, 12, and 24 months.
•   RESULTS: A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 +/- 13.1
    years; 71% women, 39.9 +/- 12.4 years) and 1,130 children (52% boys, 6.5 +/- 3.9 years; 48% girls, 7.0 +/-
    4.3 years). Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 +/- 8 years.
    The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in
    children. Disease severity decreased significantly (p < 0.001) between baseline and 24 months (adults from
    6.2 +/- 1.7 to 3.0 +/- 2.2; children from 6.1 +/- 1.8 to 2.2 +/- 1.9). Physicians' assessments yielded similar
    results. For adults and young children, major improvements were observed for quality of life, whereas no
    changes were seen in adolescents. Younger age and more severe disease at baseline were factors predictive
    of better therapeutic success.
•   CONCLUSION: Disease severity and quality of life demonstrated marked and sustained improvements
    following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a
    beneficial role in the long-term care of patients with chronic diseases.
• ObservationalConclusions world
               studies capture real
  outcomes
• Advantages for homeopathic research
  – Practitioners can participate in network toward
    larger sample sizes than one site can recruit
  – Longer duration than randomized controlled trials
  – Complex patients in true environmental context
  – Global outcome ratings as well as local changes
• Design issues – prospective, cohort, non-
  inferiority to conventional care
                  Contact Us
   Todd Rowe MD, MD(H), CCH, DHt
American Medical College of Homeopathy
        President@AMCofH.org
           www.AMCofH.org
School Director Survey:
  http://www.surveymonkey.com/s.aspx?sm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3d
Teacher Survey:
   http://www.surveymonkey.com/s.aspx?sm=9xQosdWlKZyUoGidvyrG5w_3d_3d
Student Survey:
   http://www.surveymonkey.com/s.aspx?sm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
               Iris R. Bell, MD PhD
             The University of Arizona
               College of Medicine
               ibell@u.arizona.edu

				
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Description: Homeopathic Technology document sample