homeopathic community research with todd rowe, md, md(h), cch
TRANSCRIPT
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 Researchbull 1 Basic Sciencebull 2 Clinical Sciencebull 3 Homeopathic Science (eg Provings)bull 4 Community Sciencebull 5 Educational Science
(Jonas Western J Med 2001)
Purpose of Community Researchbull Helps us to better understand the homeopathic
community including ndash Demographicsndash Success Ratesndash Cost Effectiveness of Treatmentndash Reasons for seeking treatmentndash Reasons for choosing a practitionerndash Effectiveness of various styles and types of
homeopathic practice
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
We have fallen into a place where everything is music
-Rumi
Types of Homeopathic Researchbull 1 Basic Sciencebull 2 Clinical Sciencebull 3 Homeopathic Science (eg Provings)bull 4 Community Sciencebull 5 Educational Science
(Jonas Western J Med 2001)
Purpose of Community Researchbull Helps us to better understand the homeopathic
community including ndash Demographicsndash Success Ratesndash Cost Effectiveness of Treatmentndash Reasons for seeking treatmentndash Reasons for choosing a practitionerndash Effectiveness of various styles and types of
homeopathic practice
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Types of Homeopathic Researchbull 1 Basic Sciencebull 2 Clinical Sciencebull 3 Homeopathic Science (eg Provings)bull 4 Community Sciencebull 5 Educational Science
(Jonas Western J Med 2001)
Purpose of Community Researchbull Helps us to better understand the homeopathic
community including ndash Demographicsndash Success Ratesndash Cost Effectiveness of Treatmentndash Reasons for seeking treatmentndash Reasons for choosing a practitionerndash Effectiveness of various styles and types of
homeopathic practice
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
(Jonas Western J Med 2001)
Purpose of Community Researchbull Helps us to better understand the homeopathic
community including ndash Demographicsndash Success Ratesndash Cost Effectiveness of Treatmentndash Reasons for seeking treatmentndash Reasons for choosing a practitionerndash Effectiveness of various styles and types of
homeopathic practice
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Purpose of Community Researchbull Helps us to better understand the homeopathic
community including ndash Demographicsndash Success Ratesndash Cost Effectiveness of Treatmentndash Reasons for seeking treatmentndash Reasons for choosing a practitionerndash Effectiveness of various styles and types of
homeopathic practice
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
AMCH Community Researchbull Homeopathic Practitioner Survey
ndash Completed 2006ndash Complete results available at wwwAMCofHorgndash 1150 participants
bull Homeopathic Patient Surveyndash Completed 2007ndash Complete results will be available at wwwAMCofHorg on
508ndash 1150 participants
bull Homeopathic Educational Surveyndash Students teachers administratorsndash Will be completed by 2009ndash Contact infoAMCofHorg for survey links
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Dispelling Myths About Homeopathic Practice
bull Myth 1 Homeopathic treatment results are due to the effects of placebo
bull Myth 2 Homeopaths treat mostly functional or psychiatric conditions
bull Myth 3 There are a sufficient number of homeopathic practitioners in the United States
bull Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull Myth 5 Success rates are the same for all homeopathic conditions
bull Myth 6 Children have better success rates than adults
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Dispelling Myths About Homeopathic Practice
bull Myth 7 Elderly patients have worse success rates than adults
bull Myth 8 Homeopathic treatment is too expensive bull Myth 9 Homeopathic treatment is equally effective
regardless of modality of treatment bull Myth 10 What patients like least about treatment is the
lack of treatment success bull Myth 11 It takes a long time to achieve success in
homeopathic treatment bull 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
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Dispelling Myths About Homeopathic Practice
bull Myth 13 It is impossible to make a living practicing homeopathic medicine
bull Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull Myth 15 Understanding how homeopathic medicine works has no impact on treatment results
bull Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
bull Myth 17 Men do equally well in homeopathic treatment as do women
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Placebo response rate is generally around
30-40bull General response rate to homeopathic
treatment was 79bull There was a lack of significant correlation
between length of time in treatment to results (r=0007 with a p value of 0862 ie 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 bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 1 Homeopathic Treatment Results are Due to
the Effects of Placebo bull Success Rates ()
58
60
62
64
66
68
70
72
74
76
78
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions
bull 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 bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 2 Homeopaths Treat Mostly Functional or
Psychiatric Conditions bull Total Respondents ()
0 5 10 15 20 25 30
Cardiology
Dental
Dermatology
Endocrinology
Environmental Toxicity
Gastrointestinal
General Health
Gynecology
Hematology
Immunology
Infectious Diseasee
Musculoskeletal
Neurology
Obstetrics
Oncology
Opthamology
Other
Preventive Medicine
Psychiatric
Pulmonology
Urology
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 3 There are sufficient numbers of
homeopathic practitioners in the US bull Levels of Practice (Practitioner Survey)
ndash Level One Appreciatorndash Level Two Experimenterndash Level Three Acute Prescriberndash Level Four Integrative Prescriber
ndash Level Five Homeopathic Practitionerbull A Primary Complaint of Patients About Homeopathic Practice (Patient
Survey)ndash Long Distance to Travel to Practitionerndash Difficulty Locating a Practitioner
bull Paucity vs Density of Practitioners in Certain States
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
National Homeopathic Practitioner Survey
121200002880003250063502200Total
120000002500002000030001000Unlicensed
40002000100025050DVM
5000100050022550LAc OMD
2500010000500020050DC
700001800030001000500Nurses
10000500020001000150ND
700025001000700400MD DO
Level OneLevel TwoLevel ThreeLevel FourLevel FivePractitioner
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
National Homeopathic Practitioner Survey
0
100
200
300
400
500
600
Level Three
(Acute Care)
Level Four
(Integrative)
Level Five
(Homeopathic)
Respondent Level ofPractice ()
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
AZ +345CO +40KS -465Missouri -98SC 4 -36VT +43
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
US National Surveys ndash Homeopathy US National Surveys ndash Homeopathy UseUse
bull Eisenberg et al 1993 telephone survey (N=1539)Eisenberg et al 1993 telephone survey (N=1539)ndash Homeopathy used by 1 of population 32 provider-Homeopathy used by 1 of population 32 provider-
based average of 6 visitsyearbased average of 6 visitsyearndash 247 partial insurance coverage for homeopathy247 partial insurance coverage for homeopathy
bull Eisenberg et al 1997 telephone survey (N=2055)Eisenberg et al 1997 telephone survey (N=2055)ndash Homeopathy used by 34 of population average of 16 Homeopathy used by 34 of population average of 16
visitsyearvisitsyear
ndash 0 insurance coverage for homeopathy0 insurance coverage for homeopathy
bull Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use Eisenberg D et al Unconventional medicine in the United States Prevalence costs and patterns of use New Engl J Med 1993 Jan 28328(4)246-52New Engl J Med 1993 Jan 28328(4)246-52
bull Eisenberg D et al Trends in alternative medicine use in the United States 1990-1997 results of a follow-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 11280(18)1569-75 up national survey JAMA 1998 Nov 11280(18)1569-75
bull Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Tindle HA et al Trends in use of complementary and alternative medicine by US adults 1997-2002 Altern Ther Health Med 2005 Jan-Feb11(1)42-9Altern Ther Health Med 2005 Jan-Feb11(1)42-9
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
QuickTimeordf and aTIFF (LZW) decompressor
are needed to see this picture
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull We found that there were many populations that were underserved by homeopathic medicine These included ndash Low income populationsndash Hispanic communityndash African American communityndash Natiumlve American communityndash Elderly
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 4 Homeopathic patients reflect the typical diversity of the US population
bull National Homeopathic Patient Survey
0
10
20
30
40
50
60
70
80
90
African
Amer
Asian Caucasian Eat Indian Hispanic Middle
Eastern
Native
American
Other
Total
Ntl Avg
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Surveybull We found that certain conditions had better success rates and
other conditions had worse success ratesbull Infectious disease conditions had the highest success rates
bull 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
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 5 Success rates are the same for all homeopathic conditions
bull National Homeopathic Patient Survey
0 20 40 60 80 100
Endocrinology
Dermatology
Psychiatric
General Health
Musculoskeletal
Pulmonology
Neurology
Cardiology
Gastrotintestinal
Immunology
Gynecology
Infectious Disease
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePractice
bull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of An observational study of patients receiving homeopathic treatment patients receiving homeopathic treatment Homeopathy Homeopathy 2004 Jan93(1)3-112004 Jan93(1)3-11
bull RESULTS A total of RESULTS A total of 782 patients782 patients presented with diseases of all major organ systems which were of 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 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 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 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) psychotropic) drugs (21) drugs for respiratory conditions (16) and antibiotics (16)
bull The great majority (89) said that homeopathy had The great majority (89) said that homeopathy had improved their physical condition 85 said that it had improved their physical condition 85 said that it had made no difference 24 said that homeopathy had made no difference 24 said that homeopathy had worsened their conditionworsened their condition
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Chronic Disease and CAM UseChronic Disease and CAM Usebull Saydah Saydah SHSH Eberhardt Eberhardt MSMS Use of complementary and Use of complementary and
alternative medicine among adults with chronic alternative medicine among adults with chronic diseases United States 2002 diseases United States 2002 J Altern Complement Med J Altern Complement Med 2006 Oct12(8)805-122006 Oct12(8)805-12
bull BACKGROUND Use of Complementary and Alternative Medicine (CAM) has increased in 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 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 people with diagnosed chronic diseases DESIGN Cross-sectional analysis was used SETTING The 2002 National Health Interview Survey was the setting PATIENTS SETTING The 2002 National Health Interview Survey was the setting PATIENTS Participants were representative of the noninstitutionalized US population 18 years and Participants were representative of the noninstitutionalized US population 18 years and older MEASUREMENTS Respondents answered questions about use of CAM and older MEASUREMENTS Respondents answered questions about use of CAM and physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease physician-diagnosed arthritis cancer cardiovascular disease diabetes and lung disease
bull RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared RESULTS Adults with diagnosed chronic diseases are more likely to use CAM compared to adults with none of the reported chronic diseases to adults with none of the reported chronic diseases Adults with arthritis aloneAdults with arthritis alone were were most likely to report ever use of CAM most likely to report ever use of CAM (596)(596) followed by followed by adults with cancer or lung adults with cancer or lung disease alone or two or more chronic diseases (55)disease alone or two or more chronic diseases (55) adults with adults with cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes cardiovascular disease (464) and adults with no chronic diseases (436) and diabetes alone (414) Adults with chronic diseases were also more likely to report use of CAM in alone (414) Adults with chronic diseases were also more likely to report use of CAM in the past 12 months (32 to 433) followed by adults with none of these chronic the past 12 months (32 to 433) followed by adults with none of these chronic diseases (32) and adults with diabetes alone (262) diseases (32) and adults with diabetes alone (262)
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveybull We found that children had worse success rates than adults in
all categories
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 6 Children have better success rates than adults
bull National Homeopathic Patient Surveyndash Blue=Success Rates for Adults ()ndash Red= Success Rates for Children ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull We found that the elderly had a trend towards slightly worse
success rates
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 7 Elderly have worse success rates than adults
bull National Homeopathic Patient Surveybull Blue=Adult Success Rates ()bull Red=Elderly Success Rates ()
0
10
20
30
40
50
60
70
80
Overall
Success
Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self-
Awareness
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Surveybull This was a major complaint of homeopathic patients in the
survey bull However the average cost of homeopathic treatment annually
was only $58078 per year bull The average cost savings of the reduction in conventional
medication and supplements was $103320 per year
bull This makes for a net cost savings of $45242 per year
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (What patients like least
about treatment [])
0 5 10 15 20
Slower Pace
Cost
Hard Work
Distance toTravel
Side Effects
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
treatment in US Dollars)
0 200 400 600 800 1000 1200
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost for
homeopathic medication in US Dollars)
0 100 200 300 400 500
Overall
Const Only
Female
Male
Sens to Remedies
Good Responders
Poor Responders
Classical
Complex
Young
Elderly
Animal
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 8 Homeopathic treatment is too expensive bull National Homeopathic Patient Survey (Average cost savings
from reduction in conventional medication in US Dollars)
0 500 1000 1500 2000 2500
Overall
Const Only
Female
Male
Sens to Remedies
Classical
Complex
Young
Elderly
Animal
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Cross-Sectional Observational Cross-Sectional Observational Study ndash Homeopathy in General Study ndash Homeopathy in General
PracticePracticebull Van Van Wassenhoven Wassenhoven MM Ives GIves G An observational study of patients receiving An observational study of patients receiving
homeopathic treatment homeopathic treatment Homeopathy 2004 Jan93(1)3-11Homeopathy 2004 Jan93(1)3-11 bull BACKGROUND Observational studies have recently contributed useful information to the debate about 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 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 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 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 a specified day completed a questionnaire RESULTS A total of 782 patients782 patients presented with presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78 of 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 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 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 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 (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 antibiotics and cardiovascular medication The antibiotics were almost exclusively (95) used to treat respiratory infections respiratory infections
bull Prescription costs (including conventional medicines) Prescription costs (including conventional medicines) were one-third of the general practice averagewere one-third of the general practice average
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 9 Homeopathic treatment is equally effective for
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull 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) Mentalemotional improvement (p=006) Physical improvement (p=0009) Well being improvement (002) Improvement in energy (p=009) Improvement in awareness (p=009)
bull 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 bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 9 Homeopathic treatment is equally effective
regardless of the modality of treatment bull National Homeopathic Patient Survey
bull Success Rates by Type of Homeopathic Treatment ()
0
10
20
30
40
50
60
70
80
Overall Main
Complaint
Mental and
Emotional
Physical Well Being Energy Self
Awareness
Classical Only
Complex Only
Combined
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey
bull 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
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 10 What patients like least about treatment is the lack of treatment success
bull National Homeopathic Patient Survey ()
0 5 10 15 20
Slower Pace
Nothing
Cost
Hard Work
Side Efects
Efficacy
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 11 It takes a long time to achieve ldquosuccessrdquo in
homeopathic treatment bull National Homeopathic Patient Survey
bull We found that this was not true
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
bull National Homeopathic Patient Survey (months)
0
1
2
3
4
5
6
Overall Female Male Sensitive Animal Classical Complex Combined Infectious
Disease
Pulmonology
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull 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
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
bull National Homeopathic Patient Survey ()bull How much of a problem have side effects been in treatment
0
5
10
15
20
25
30
35
Extremely High High Modeerate Low Extremely Low Not At All
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom
seen in treatment bull National Homeopathic Patient Survey ()
bull 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
0
10
20
30
40
50
60
70
80
New Symptoms Old Symptoms
Side effects as
New vs Old
Symptoms
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Observational Study ndash Homeopathy Observational Study ndash Homeopathy AcutesAcutes
bull Haidvogl MHaidvogl M Riley DSRiley DS Heger Heger MM Brien Brien SS Jong Jong MM Fischer MFischer M Lewith Lewith GTGT Jansen GJansen G Thurneysen Thurneysen AEAE Homeopathic and conventional treatment for acute Homeopathic and conventional treatment for acute respiratory and ear complaints a comparative study on outcome in the respiratory and ear complaints a comparative study on outcome in the primary care setting primary care setting BMC Complement Altern Med 2007 Mar 277BMC Complement Altern Med 2007 Mar 277
bull The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of The primary outcome criterion was the response rate after 14 days of therapy RESULTS Data of 1577 patients1577 patients were were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment The majority of 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 patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were 869 C 860 p = 00003 for non-inferiority testing) In the per-protocol set (H 576 and C 540 patients) similar results were obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of obtained (H 877 C 869 p = 00019) Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio response rates after 14 days in children (H 885 C 845) and adults (H 856 C 866) The unadjusted odds ratio (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) in adults Adjustments for (OR) of the primary outcome criterion was 140 (089-222) in children and 092 (063-134) 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 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 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 = 00488) and adults (p = 00001) was significantly faster upon homeopathic treatment both in children (p = 00488) and adults (p = 00001)
bull Adverse drug reactions occurred more frequently in adults of the conventional Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C 76 H 31 p = 00032) whereas in group than in the homeopathic group (C 76 H 31 p = 00032) whereas in children the occurrence of adverse drug reactions was not significantly children the occurrence of adverse drug reactions was not significantly different (H 20 C 24 p = 07838)different (H 20 C 24 p = 07838)
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()bull The overall average income of homeopathic practitioners was $450080 per
month This translates into a yearly income of $4950880 (11 months) For level five practitioners the overall average annual income was $10130604
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 13 It is impossible to make a living practicing homeopathic medicine
bull National Homeopathic Practitioner Survey ()
0
5000
10000
15000
20000
None MD ND RN DVM OMDLAc
Average Monthly
Income ($)
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 14 The homeopathic system of treatment makes a significant difference in treatment results
bull National Homeopathic Patient Survey ()bull 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 bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 15 Understanding how homeopathic medicine works
has no impact on treatment results bull National Homeopathic Patient Survey ()
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 15 Understanding how homeopathic medicine works
has no impact on treatment results bull National Homeopathic Patient Survey
bull Success Rates ()
66
68
70
72
74
76
78
80
82
Overall High Understanding Low Understanding
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Openness Personality Trait Predicts Openness Personality Trait Predicts Complementary amp Alternative Medicine Complementary amp Alternative Medicine
UseUse (N=3032) (N=3032) (Honda amp Jacobson Prev Med (Honda amp Jacobson Prev Med 40(1)46-5340(1)46-53 2005)2005)
Alternative Medical Systems
Energy Therapies
Any CAM
Agreeableness 169 241 106
Neuroticism 130 079 088
Openness 355 (133-944)
1577 (286-8687)
165 (118-231)
Extraversion 085 096 065 (046-091)
Conscientiousness 090 164 094
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull 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 bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer
treatment results bull National Homeopathic Patient Survey
bull Success Rates ()
0
20
40
60
80
100
Overall Physical Self
Awareness
Overall Success
Rates ()
Sensitive to
Conventional Meds
Senstive to
Homeoapthic Meds
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 17 Men do equally well in homeopathic treatment than
do women
bull National Homeopathic Patient Surveybull We found that women did consistently better in homeopathic
treatment than did males
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Be tter Se lf-Rated Outcome s in Women v s Men with Homeopathic TreatmentWilks lambda=95890 F(7 651)=39860 p=00028
Vertical bars denote 095 confidence intervals
Female Male
GENDER
68
70
72
74
76
78
80
82
84
Overall Treatment Success (0-100)
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Demographics of Higher CAM Demographics of Higher CAM Users 62 of 31 044 interviewsUsers 62 of 31 044 interviews
(Barnes et al Adv Data 2004 May 27(Barnes et al Adv Data 2004 May 27(343)1-192004)(343)1-192004)
bull AgeAge OlderOlderbull GenderGender 693 female693 femalebull EducationEducation College and aboveCollege and abovebull Socioeconomic StatusSocioeconomic Status HigherHigherbull Region of USRegion of US Western statesWestern states
See also Ni HSee also Ni H Simile CSimile C Hardy AMHardy AM Utilization of complementary and alternative Utilization of complementary and alternative medicine by United States adults results from the 1999 national health medicine by United States adults results from the 1999 national health interview survey interview survey Med Care 2002 Apr40(4)353-8Med Care 2002 Apr40(4)353-8
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment
over conventional therapies
bull National Homeopathic Patient Surveybull CAM Research
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
0 5 10 15 20 25 30
It Works
Safe
Holistic
Natural
My Practitioner
Simplicity
Deep Healing
Fast
Promoting Wellness
inexpensive
Other
Individualized
Non-Suppressive
Tx of Family
Philosophy
Empowered
Everything
Thoroughness
Freedom
Tastes Good
Convenience
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Predictors of CAM Use (Astin JAMA 279(19)1548-53 1998)
(N=1035 random mail survey)(N=1035 random mail survey) more educationmore education poorer health statuspoorer health status holistic orientation to healthholistic orientation to health transformational experiencetransformational experience certain health problemscertain health problems
anxietyanxiety back problemsback problems chronic painchronic pain urinary tract problemsurinary tract problems
certain cultural groupscertain cultural groups
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Perceived Benefits from CAM Use (Astin JAMA 1998)
ldquoldquoI get relief for my symptoms the pain or I get relief for my symptoms the pain or discomfort is less or goes away I feel discomfort is less or goes away I feel betterrdquo (perceived efficacy)betterrdquo (perceived efficacy)
ldquoldquoThe treatment works better for my The treatment works better for my particular health problem than standard particular health problem than standard medicinersquosrdquo (perceived efficacy)medicinersquosrdquo (perceived efficacy)
ldquoldquoThe treatment promotes health rather The treatment promotes health rather than just focusing on illnessrdquo than just focusing on illnessrdquo (philosophical congruence)(philosophical congruence)
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Parameters that Effect Results
Average Response RatePast Treatment Failures
Slightly Improved Response RatePast Treatment Responders
Average Response RateFrequent Visits to Practitioner
Slightly Improved Response RateLong Length of Treatment
Average Response RateCombined Classical and Complex
Slightly Reduced Response RateComplex Homeopathy
Average Response RateClassical Homeopathy
Slightly Improved Response RateSensitivity to Homeopathic Medication
Slightly Improved Response RateSensitivity to Conventional Medication
Average Response RateEducational Level
Married Patients Get Better ResultsMarital Status
Animals show the same response rate as humansSpecies
Younger patients do not respond as well to treatment elderly patients show an average response
Age
Women get better results then menSex
ResultParameter
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Parameters that Effect Results
Reduced Response RateHigh Cost
Average Response RateCardiology Dermatology Gastrointestinal Musculoskeletal Neurological Psychiatric Pulmonary chief complaint
Improved Response RateUnderstanding How Homeopathy Works
Reduced Response RateLow Compliance With Treatment
Reduced Response RateStrong Side Effects
Reduced Response RateFrequent Antidoting
Average Response RatePolycrest Prescriptions
Improved Response RateGynecology Immunology Infectious Disease chief complaint
Reduced response rateEndocrinology chief complaint
ResultParameter
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
NoYesPhilosophy
NoYesSelf Treatment
DependentEmpoweredRelationship with Practitioner
Disease FocusedWellness FocusedFocus of Treatment
Not HeardCaring and TrustPractitioner Communication
ComplexSimpleStyle of Treatment
ArtificialNaturalNature of Treatment
SuppressiveHolisticDirection of Cure
Less EffectiveMore EffectiveEfficacy
More ExpensiveLess ExpensiveCost (Medication)
More expensiveLess ExpensiveCost (Treatment)
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
LowerHigherPatient Level of Education
InsuranceOut of PocketPayment for Tx
SmallerLargerFormulary
LowerHigherPatient Sensitivity
LowerHigherPatient Loyalty
Diagnostic FocusTotality FocusedFocus of Interview
BriefTime IntensiveInterview
WorseBetterCompliance
EasierHarderPatient Understanding of Treatment
EasierHarderDifficulty to Practice
GoodPoorAvailability of Practitioners
SuperficialDeepEffects of Treatment
HarshGentleSafety
Conventional MedicineHomeopathic MedicineDescription
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
AnimalsAnimals and PlantsOther Patient Populations
AllAllAges
More Even DistributionMore CaucasianEthnicity
More Even DistributionMore WomenSex
Conventional MedicineHomeopathic MedicineDescription
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Caveats on Data (Bias)bull 1 Volunteer Patientsbull 2 Comfort level with on-line communications
and technologybull 3 Methods of reaching patientsbull 4 Memory based databull 5 Heterogeneity of subject popuationbull 6 Sample sizebull 7 Confusion of terms (eg ldquosuccessrdquo)
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Limitations of Survey DataLimitations of Survey Databull Recruitment biasRecruitment bias
ndash People with telephonesPeople with telephonesndash People with computersPeople with computersndash People with homesPeople with homes
bull Retrospective recall in cross-sectional Retrospective recall in cross-sectional designsdesignsndash Faulty memoryFaulty memoryndash Causal attribution of response less clearCausal attribution of response less clear
bull Susceptible to phrasing of question (cf Susceptible to phrasing of question (cf push-polling in political surveys)push-polling in political surveys)
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Recommendations and Future Directionsbull 1 The homeopathic community needs to train
more homeopathic practitioners bull 2 The homeopathic community needs to reach
out to more diverse ethnic groups for treatment bull 3 The homeopathic community needs to find
better ways of reaching men in homeopathic treatment
bull 4 Further research needs to be done on comparing the efficacy of complex vs classical homeopathic treatments
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Recommendations and Future Directionsbull 5 Further research needs to be done
comparing the results of this survey to other alternative medicine fields within the United States
bull 6 Further research needs to be done comparing the results of this survey to international homeopathic studies
bull 7 Further research needs to be done comparing the efficacy of hahnemannian methods vs more modern methods of prescribing
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Recommendations and Future Directionsbull 8 The homeopathic community should seek out
methods to improve affordability for its patients bull 9 Research needs to be done on reevaluating the
potential for homeopathic treatment to cause side effects (other than a return of old symptoms)
bull 10 The homeopathic community needs to do a better job in educating its patients about how homeopathic medicine works
bull 11 The homeopathic community should develop better marketing strategies that reflect the needs of their patients
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Recommendations and Future Directionsbull 12 The homeopathic community needs to find way to
attract younger practitioners into the profession bull 13 The homeopathic community needs to find ways
to attract more men to the field bull 14 The homeopathic community needs to find ways
to attract more ethnically diverse practitioners especially African Americans and Hispanics
bull 15 The homeopathic community needs to do a better job at attracting homeopathic practitioners as their first career
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Recommendations and Future Directionsbull 16 The homeopathic community needs to find ways to
increase the length of veterinary homeopathic education bull 17 The homeopathic community needs to find ways to attract
DCrsquos and PArsquos to the homeopathic profession bull 18 The homeopathic community needs to charge more for
homeopathic services bull 19 The homeopathic community needs to find ways to make
the homeopathic profession more lucrative for its membership bull 20 Better define success in treatment in future surveys
bull 21 These surveys should be repeated every 7 years bull 22 Standardize case taking and case follow up data collection
with appropriate questionnaires
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Observational Study ndash GP Homeopathy Observational Study ndash GP Homeopathy OutcomesOutcomes
bull Guumlthlin Guumlthlin CC Lange OLange O Walach Walach HH Measuring the effects of acupuncture and Measuring the effects of acupuncture and homoeopathy in general practice an uncontrolled prospective documentation homoeopathy in general practice an uncontrolled prospective documentation approach approach BMC Public Health 2004 Mar 446BMC Public Health 2004 Mar 446
bull BACKGROUND Despite the increasing demand for acupuncture and homoeopathy in 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 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 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 by a German health insurer Patients were followed-up for up to four yearsfour years METHODS The METHODS The aim of the project was to study the effects and benefits of acupuncture andor homoeopathy aim of the project was to study the effects and benefits of acupuncture andor homoeopathy and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture 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 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 available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36) these were complemented by questions concerning the patients medical history (MOS SF-36) these were complemented by questions concerning the patients medical history and by questions on patient satisfaction The health insurer provided us with data on work and by questions on patient satisfaction The health insurer provided us with data on work absenteeism absenteeism
bull RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle RESULTS Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire to large-sized effects for the quality of life questionnaire SF-36 SF-36 and about 1 point improvement and about 1 point improvement on a rating scale of effects given by doctors Data on the treatment and the patients and 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 physicians background suggests chronically ill patients treated by fairly regular schemes
bull CONCLUSION Since the results showed evidence of a subjective benefit for patients from 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 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 treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previouslytreatment given previously
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Observational Study ndash Homeopathy amp Observational Study ndash Homeopathy amp Chronic DiseasesChronic Diseases
bull Witt CMWitt CM Luumldtke Luumldtke RR Baur Baur RR Willich Willich SNSN Homeopathic medical practice long- Homeopathic medical practice long-term results of a cohort study with 3981 patients BMC Public Health 2005 Nov term results of a cohort study with 3981 patients BMC Public Health 2005 Nov 35115 Links35115 Links
bull BACKGROUND On the range of diagnoses course of treatment and long-term outcome in patients who 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 chose to receive homeopathic medical treatment very little is known We investigated homeopathic practice
in an industrialized country under everyday conditions METHODS In a in an industrialized country under everyday conditions METHODS In a prospective multicentre prospective multicentre cohort study with 103 primary care practicescohort study with 103 primary care practices with additional specialisation in homeopathy in with additional specialisation in homeopathy in Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time Germany and Switzerland data from all patients (age gt 1 year) consulting the physician for the first time were observed The main outcome measures were Patient and physician assessments (numeric rating 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 scales from 0 to 10) and quality of life at baseline and after 3 12 and 24 months
bull RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 RESULTS A total of 3981 patients were studied including 2851 adults (29 men mean age 425 +- 131 years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- years 71 women 399 +- 124 years) and 1130 children (52 boys 65 +- 39 years 48 girls 70 +- 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years 43 years) Ninety-seven percent of all diagnoses were chronic with an average duration of 88 +- 8 years The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in The most frequent diagnoses were allergic rhinitis in men headache in women and atopic dermatitis in children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from children Disease severity decreased significantly (p lt 0001) between baseline and 24 months (adults from 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar 62 +- 17 to 30 +- 22 children from 61 +- 18 to 22 +- 19) Physicians assessments yielded similar results For adults and young children major improvements were observed for quality of life whereas no 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 changes were seen in adolescents Younger age and more severe disease at baseline were factors predictive of better therapeutic success predictive of better therapeutic success
bull CONCLUSION Disease severity and quality of life demonstrated marked and sustained improvements 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 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 diseasesbeneficial role in the long-term care of patients with chronic diseases
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
ConclusionsConclusionsbull Observational studies capture real world Observational studies capture real world
outcomesoutcomesbull Advantages for homeopathic researchAdvantages for homeopathic research
ndash Practitioners can participate in network toward Practitioners can participate in network toward larger sample sizes than one site can recruitlarger sample sizes than one site can recruit
ndash Longer duration than randomized controlled trialsLonger duration than randomized controlled trialsndash Complex patients in true environmental contextComplex patients in true environmental contextndash Global outcome ratings as well as local changesGlobal outcome ratings as well as local changes
bull Design issues ndash prospective cohort non-Design issues ndash prospective cohort non-inferiority to conventional careinferiority to conventional care
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-
Contact UsTodd Rowe MD MD(H) CCH DHtTodd Rowe MD MD(H) CCH DHt
American Medical College of HomeopathyAmerican Medical College of HomeopathyPresidentAMCofHorgPresidentAMCofHorg
wwwAMCofHorgwwwAMCofHorgSchool Director Survey
httpwwwsurveymonkeycomsaspxsm=VmCGU4ssIqnMa9_2frqk3KZQ_3d_3dTeacher Survey
httpwwwsurveymonkeycomsaspxsm=9xQosdWlKZyUoGidvyrG5w_3d_3dStudent Survey httpwwwsurveymonkeycomsaspxsm=BWYvX6fEUhYW4qUtnuwI4A_3d_3d
Iris R Bell MD PhDIris R Bell MD PhDThe University of Arizona The University of Arizona
College of MedicineCollege of Medicineibelluarizonaeduibelluarizonaedu
- Homeopathic Community Research with Todd Rowe MD MD(H) CCH DHt and Iris Bell MD MD(H) PhD
- PowerPoint Presentation
- Types of Homeopathic Research
- Slide 4
- Purpose of Community Research
- AMCH Community Research
- Dispelling Myths About Homeopathic Practice
- Slide 8
- Slide 9
- Myth 1 Homeopathic Treatment Results are Due to the Effects of Placebo
- Slide 11
- Myth 2 Homeopaths Treat Mostly Functional or Psychiatric Conditions
- Slide 13
- Slide 14
- Myth 3 There are sufficient numbers of homeopathic practitioners in the US
- National Homeopathic Practitioner Survey
- Slide 17
- National Homeopathic Practitioner Survey What Patients Like Least About Treatment ()
- National Homeopathic Practitioner Survey Relative Distribution of Homeopathic Practitioners per Capita
- Slide 20
- Slide 21
- US National Surveys ndash Homeopathy Use
- Slide 23
- Myth 4 Homeopathic patients reflect the typical diversity of the US population
- Slide 25
- Myth 5 Success rates are the same for all homeopathic conditions
- Slide 27
- Cross-Sectional Observational Study ndash Homeopathy in General Practice
- Chronic Disease and CAM Use
- Myth 6 Children have better success rates than adults
- Slide 31
- Myth 7 Elderly have worse success rates than adults
- Slide 33
- Myth 8 Homeopathic treatment is too expensive
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Myth 9 Homeopathic treatment is equally effective for regardless of the modality of treatment
- Myth 9 Homeopathic treatment is equally effective regardless of the modality of treatment
- Myth 10 What patients like least about treatment is the lack of treatment success
- Slide 43
- Myth 11 It takes a long time to achieve ldquosuccessrdquo in homeopathic treatment
- Slide 45
- Myth 12 Side effects to homeopathic treatment where new symptoms develop (not return of old symptoms) are seldom seen in treatment
- Slide 47
- Slide 48
- Observational Study ndash Homeopathy Acutes
- Myth 13 It is impossible to make a living practicing homeopathic medicine
- Slide 51
- 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
- Slide 54
- Openness Personality Trait Predicts Complementary amp Alternative Medicine Use (N=3032) (Honda amp Jacobson Prev Med 40(1)46-53 2005)
- Myth 16 Those patients who are sensitive to conventional medications or to homeopathic medicines have poorer treatment results
- Slide 57
- Myth 17 Men do equally well in homeopathic treatment than do women
- Demographics of Higher CAM Users 62 of 31 044 interviews (Barnes et al Adv Data 2004 May 27(343)1-192004)
- Myth 18 The main reason that people choose homeopathic treatment is that they are choosing homeopathic treatment over conventional therapies
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Parameters that Effect Results
- Slide 67
- Comparison of Homeopathic and Conventional Medicine As Perceived by Patients
- Slide 69
- Slide 70
- Caveats on Data (Bias)
- Limitations of Survey Data
- Recommendations and Future Directions
- Slide 74
- Slide 75
- Slide 76
- Slide 77
- Observational Study ndash GP Homeopathy Outcomes
- Observational Study ndash Homeopathy amp Chronic Diseases
- Conclusions
- Contact Us
-