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PubMed2004

An overview of two Cochrane systematic reviews of complementary treatments for chronic asthma: acupuncture and homeopathy.

BACKGROUND: Acupuncture and homeopathy are commonly used complementary treatments for chronic asthma. This review summarizes two recently updated Cochrane systematic reviews that assess the safety and efficacy of homeopathy or acupuncture in individuals with chronic stable asthma. INCLUSION CRITERIA: Only randomized-controlled trials were considered for inclusion. Statistical aggregation of the data was undertaken where possible. SEARCH STRATEGY: Searches for both reviews were done with the assistance of the Cochrane Airways Group, and through electronic alerts. RESULTS: ACUPUNCTURE: 11 studies with 324 participants met the inclusion criteria. Trial reporting was poor, and the trial quality was deemed inadequate to generalize the findings. There was variation in the type of active and sham acupunctures, the outcomes assessed and the time points measured. The points used in the sham arm of some studies are used for the treatment of asthma according to traditional Chinese medicine. Two studies used individualized treatment strategies, and one study used a combination strategy of formula acupuncture with the addition of individualized points. No statistically significant or clinically relevant effects were found for acupuncture compared with sham acupuncture. When data from two small studies were pooled, no difference in lung function was observed (post-treatment FEV1): standardized mean difference 0.12, 95% confidence interval 0.31 to 0.55). CONCLUSION: ACUPUNCTURE: There is not enough evidence to recommend the use of acupuncture in the treatment of asthma. Further research needs to be undertaken, and this should take into account the different types of acupuncture practiced. RESULTS: HOMEOPATHY: Six trials with a total of 556 people were included in the review. These trials were all placebo-controlled and double-blind, but were of variable quality. Standardized treatments in these trials are unlikely to represent common homeopathic practice where treatment tends to be individualized. The results of the studies are conflicting in terms of effects on lung function. There has been only a limited attempt to measure a "package of care" effect (i.e. the effect of the medication as well as the consultation, which is considered a vital part of individualized homeopathic practice). CONCLUSION: HOMEOPATHY: There is not enough evidence to reliably assess the possible role of homeopathy in the treatment of asthma. Further studies could assess whether individuals respond to a "package of care" rather than the homeopathic intervention alone.

Acupuncture Therapy↗
PubMed2000

Homeopathy and general practice: an urban perspective.

Complementary medicine appears to be an increasingly popular option amongst both doctors and patients. General practitioners (GPs) in more affluent parts of Britain have showed considerable interest in its use. Our objectives were to ascertain the use of and attitudes towards homeopathy amongst GPs working in a socio-economically deprived urban area such as Liverpool. A postal questionnaire survey was carried out of all general practice principals in Liverpool, using freepost envelopes and one reminder after three weeks. With respect to eight common complementary therapies in general and homeopathy in particular, respondents were asked whether they treat with, refer to or endorse each therapy; and their views were questioned on NHS funding, effectiveness, adverse reactions, training needs and theoretical validity, for each therapy. The response rate was 131/252 (52%), and was higher amongst women and doctors aged under 40 y. During the previous week 37 (28%) GPs had been involved in homeopathy with their patients: 6.5% had treated directly, 18.5% had referred to, and 7% had endorsed homeopathy. 31% of GPs reported successful outcomes by homeopathic treatment compared with 14% reporting adverse effects. Respondents were generally uncertain about the validity of the theoretical basis of homeopathy; only 23% considered it to have a valid basis.

Adult↗
PubMed1998

Randomized controlled trials of individualized homeopathy: a state-of-the-art review.

BACKGROUND AND OBJECTIVE: Individualized homeopathy is the most controversial form of this therapy. This review aims to summarize the actual state of clinical efficacy research on individualized homeopathy. METHODS: Electronic databases as well as other sources were searched for possibly relevant studies. Randomized or quasirandomized controlled clinical trials comparing an individualized homeopathic treatment strategy with placebo, no treatment, or another treatment were eligible. Information on patients, methods, interventions, outcomes, and results was extracted in a standardized manner and quality was assessed using a checklist and two scoring systems. Trials providing sufficient data were pooled in a quantitative meta-analysis. RESULTS: A total of 32 trials (28 placebo-controlled, 2 comparing homeopathy and another treatment, 2 comparing both) involving a total of 1778 patients met the inclusion criteria. The methodological quality of the trials was highly variable. In the 19 placebo-controlled trials providing sufficient data for meta-analysis, individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62, 95% confidence interval 1.17 to 2.23), but when the analysis was restricted to the methodologically best trials no significant effect was seen. CONCLUSION: The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies. Future research should focus on replication of existing promising studies. New randomized studies should be preceded by pilot studies.

Confounding Factors, Epidemiologic↗
PubMed1999

Ignorance about homeopathy.

Three hundred and three (303) adults selected by a research consultancy were asked six open-ended questions about homeopathy to ascertain their beliefs, knowledge, and behavior. Just over 40% said homeopathy meant to them "natural or herbal medicine"; while approximately one third said they do not know how homeopathy "works." Just under one third believed that homeopathy was available on the British National Health Service, while two thirds agreed that it was quite easy to get homeopathic treatment. Despite its popularity, people remain surprisingly ignorant about homeopathy.

Adolescent↗
PubMed2004

Comparison of homeopathy, placebo and antibiotic treatment of clinical mastitis in dairy cows - methodological issues and results from a randomized-clinical trial.

Based on the widespread use of homeopathy in treatment of animal disease and the poor documentation of its possible effects and consequences, a clinical trial was carried out in order to evaluate the efficacy of homeopathy in treatment of clinical mastitis in dairy cows and a design for clinical studies on homeopathic treatment, taking into account the guidelines for randomized-clinical trials (RCT) as well as the basic principles of homeopathy. A three-armed, stratified, semi-crossover design comparing homeopathy, placebo and a standardized antibiotic treatment was used. Fifty-seven dairy cows were included. Evaluation was made by two score scales, with score I measuring acute symptoms and score II measuring chronic symptoms, and by recording the frequencies of responders to treatment based on four different responder definitions. Significant reductions in mastitis signs were observed in all treatment groups. Homeopathic treatment was not statistically different from either placebo or antibiotic treatment at day 7 (P = 0.56, P = 0.09) or at day 28 (P = 0.07, P = 0.35). The antibiotic treatment was significantly better than placebo measured by the reduction in score I (P < 0.01). Two-thirds of the cases both in the homeopathy and placebo groups responded clinically within 7 days. The outcome measured by frequencies of responders at day 28 was poor in all treatment groups. Evidence of efficacy of homeopathic treatment beyond placebo was not found in this study, but the design can be useful in subsequent larger trials on individualized homeopathic treatment.

Animals↗
PubMedDate not supplied

Homeopathy and women's health care.

A 1997 survey revealed that 40% of Americans use some type of complementary therapy or medicine and that many use such therapies in conjunction with treatments prescribed to them by conventional medical practitioners. One alternative modality that is growing in popularity is homeopathy. Although use of this modality is growing, many health care providers know very little about it. This article provides an introduction to homeopathy, including its historical origins and theoretical principles. Also included is a review of two meta-analyses that examined the efficacy of homeopathy in clinical trials. The homeopathic approach to prolonged pregnancy is presented as an example of a potential application to women's health. Information on education and certification in homeopathy is provided, along with resources on homeopathy available to women's health care providers. Implications for nursing practice are discussed.

Adult↗
PubMed2001

Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy.

BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with homeopathy. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of homeopathy; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. RESULTS: Eighteen out of 22 potentially relevant reviews preselected in the screening process met the inclusion criteria. Six reviews addressed the question whether homeopathy is effective across conditions and interventions. The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. INTERPRETATION: Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy.

Asthma↗
PubMed2006

Hormesis, epitaxy, the structure of liquid water, and the science of homeopathy.

According to the western medical establishment, homeopathy is both "unscientific" and "implausible". A short overview of its history and the methods it uses, however, easily reveals that homeopathy is a true science, fully grounded on the scientific method and on principles, such as, among others, the Arndt-Schultz law, hormesis, and epitaxy, whose plausibility has been clearly and definitely demonstrated in a number of scientific publications and reports. Through a review of the scientific literature, an explanation of the basic principles of homeopathy is proposed based on arguments and evidence of mainstream science to demonstrate that, in spite of the claims of conventional medicine, homeopathy is both scientific and plausible and that there is no reasonable justification for its rejection by the western medical establishment. Hopefully, this hurdle will be overcome by opening academic institutions to homeopathy to enlarge the horizons of medical practice, recover the value of the human relationship with the patient, and through all this, offer the sick a real alternative and the concrete perspective of an improved quality of life.

Dose-Response Relationship, Drug↗
PubMed1996

[History of "special therapeutic directions": the example of homeopathy].

As for generally accepted therapeutic methods, the "special methods" may appear to be effective due to spontaneous recovery provided by nature. A great number of sceptical physicians are aware of this fact. The pharmacologist works continuously to differentiate effects directly caused by medical treatments - mainly drugs - from effects resulting from spontaneous recovery. This is one of the most difficult problems in medical treatment. As a representative example of all "special methods", we concentrate here on the history of homeopathy. As is generally known, there is no conformity in homeopathy, for example monotherapy versus therapy with complex homeopathic products; refusing the simile-rule; treatment with high potencies versus treatment with low potencies; classic versus scholastic homeopathy. The number of homeopathies really equals the number of homeopathic physicians. For this reason, instruction in homeopathy on the academic level is impossible. In addition, we have to forget all natural laws only to prove that "potentiation" may be true. Therapeutic success due purely to chance may be explained rationally and is occasionally seen in all other "special methods". The theories of homeopaths for the action with homeopathic products are neither in accordance with our natural laws nor comply with a rational philosophy.

Complementary Therapies↗
PubMed2006

Immunology and homeopathy. 4. Clinical studies-part 2.

The clinical studies on the effectiveness of homeopathy in respiratory allergy (18 randomized trials and 9 observational studies) are described. The literature of common immunologic disorders including also upper respiratory tract infections (URTI) and otorhinolaryngology (reported in part 1), is evaluated and discussed. Most of initial evidence-based research was addressed to the question of whether homeopathic high dilutions are placebos or possess specific effects, but this question has been often equivocal and is still a matter of debate. The evidence demonstrates that in some conditions homeopathy shows significant promise, e.g. Galphimia glauca (low dilutions/potencies) in allergic oculorhinitis, classical individualized homeopathy in otitis and possibly in asthma and allergic complaints, and a few low-potency homeopathic complexes in sinusitis and rhinoconjunctivitis. A general weakness of evidence derives from lack of independent confirmation of reported trials and from presence of conflicting results, as in case of homeopathic immunotherapy and of classical homeopathy for URTI. The suitable methods to evaluate homeopathy effectiveness, without altering the setting of cure, are also analyzed.

Journal Article↗
PubMed1998

A double-blind, controlled clinical trial of homeopathy and an analysis of lunar phases and postoperative outcome.

OBJECTIVE: To use scientific methods to evaluate 2 claims made by practitioners of alternative medicine. DESIGN: A placebo-controlled, double-blind study of homeopathy in children with warts, and a cohort study of the influence of lunar phases on postoperative outcome in surgical patients. SETTING: Outpatients of a dermatology department (homeopathy study) and inpatients evaluated at an anesthesiology department (lunar phases). SUBJECTS: Sixty volunteers for the homeopathy study and 14,970 consecutive patients undergoing surgery under general anesthesia for the lunar phase study. INTERVENTIONS: Treatment of children with warts with individually selected homeopathic preparations (homeopathic study); surgical procedures including abdominal, vascular, cardiac, thoracic, plastic, and orthopedic operations and assessment of the lunar phase at the time of operation (lunar phase study). MAIN OUTCOME MEASURES: Reduction of area occupied by warts by at least 50% within 8 weeks; death from any cause within 30 days after surgery. RESULTS: Nine of 30 subjects in the homeopathy group and 7 of 30 subjects in the placebo group experienced at least 50% reduction in area occupied by warts (chi 2 = 0.34; P = .56); the mortality rate was 1.20% in patients operated on during waxing moon and 1.33% in patients operated on during waning moon (chi 2 = 0.49; P = .50). CONCLUSIONS: Statements and methods of alternative medicine--as far as they concern observable clinical phenomena--can be tested by scientific methods. When such tests yield negative results, as in the studies presented herein the particular method or statement should be abandoned. Otherwise one would run the risk of supporting superstition and quackery.

Double-Blind Method↗
PubMedDate not supplied

Patient characteristics and practice patterns of physicians using homeopathy.

BACKGROUND: The use of homeopathy is growing in the United States, but little is known about practice patterns of physicians using homeopathy and the patients who seek homeopathic care. MATERIALS AND METHODS: Data for consecutive patient visits to 27 doctors of medicine and doctors of osteopathy using homeopathy in 1992 were collected and compared with the National Ambulatory Medical Care Survey of 1990. RESULTS: Patients seen by the homeopathic physicians were younger, more affluent, and more likely to present with long-term complaints. Physicians using homeopathic medicine surveyed spent more time with their patients, ordered fewer tests, and prescribed fewer pharmaceutical medications than physicians practicing conventional medicine. CONCLUSIONS: While definite conclusions cannot be made based on this survey, we have documented that the use of diagnostic testing and conventional medications by physicians who use homeopathy to treat common chronic conditions is well below that of conventional primary care physicians. These findings, if associated with comparable clinical outcomes, suggest a potential for substantial cost savings. Further studies documenting outcomes, cost benefits, physician decision-making, and patient satisfaction will be required to further explore this subject.

Adolescent↗
PubMed2004

Homeopathy for chronic asthma.

BACKGROUND: Homeopathy involves the use, in dilution, of substances which cause symptoms in their undiluted form. It is one of the most widespread forms of complementary medicines and is also used to treat asthma. OBJECTIVES: The objective of this review was to assess the effects of homeopathy in people with chronic stable asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, the Cochrane Complementary Medicine Field trials register, the Glasgow Homeopathic Hospital database, the Münchener Modell database and reference lists of articles. Searches were current as of August 2003. SELECTION CRITERIA: Randomised trials of homeopathy for the treatment of stable chronic asthma, with observation periods of at least one week were included. DATA COLLECTION AND ANALYSIS: Data extraction was undertaken by two reviewers. Trial quality was assessed by the reviewers. MAIN RESULTS: Six trials with a total of 556 people were included. These trials were all placebo-controlled and double-blind, but of variable quality. They used different homeopathic treatments which precluded quantitative pooling of results for the primary outcome. Standardised treatments in these trials are unlikely to represent common homeopathic practice, where treatment tends to be individualised. No trial reported a significant difference on validated symptom scales. There were conflicting results in terms of lung function between the studies. There has been only a limited attempt to measure a 'package of care' effect (i.e., the effect of the medication as well as the consultation, which is considered a vital part of individualised homeopathic practice). REVIEWER'S CONCLUSIONS: There is not enough evidence to reliably assess the possible role of homeopathy in asthma. As well as randomised trials, there is a need for observational data to document the different methods of homeopathic prescribing and how patients respond. This will help to establish to what extent people respond to a 'package of care' rather than the homeopathic intervention alone.

Asthma↗
PubMed2003

Exploring General Practitioners' attitudes to homeopathy in Dumfries and Galloway.

This comparative quantitative study explored General Practitioners' (GPs) attitudes to homeopathy in Dumfries and Galloway, a predominantly rural area in South West Scotland where there is a local British Homeopathic Association Funded Homeopathic Clinic. It aimed to determine whether there was an association between expressed attitudes to homeopathy and a number of variables. Issues arising from the House of Lords Report on CAM were also explored. A self-administered questionnaire was addressed to all 135 GPs within Dumfries and Galloway. Descriptive statistics were used in the data analysis. The response rate was 75%. The NHS GP clinic accounted for 47% of total referrals for homeopathy. A total of 86.1% of GPs within Dumfries and Galloway were in favour of a local NHS Homeopathic Specialist Clinic. Forms of evidence most influential to GPs regarding homeopathy were: randomised controlled trials; audit data on patient outcomes; safety and patient satisfaction.

Attitude of Health Personnel↗
PubMed2003

Antibiotics and the development of resistant microorganisms. Can homeopathy be an alternative?

Antibiotic resistance is a global public health problem. Once confined primarily to hospitals it is now increasingly common in primary care. The prevalence of resistant bacteria is rising, and organisms resistant to almost all antibiotics have been identified. The main causes are indiscriminate prescribing and the use of antibiotics in animal feeds and other agricultural applications. Policies to restrict use of antibiotics have had limited success. Homeopathy may have a role to play in combating the development of antibiotic resistance. Clinical research suggests that homeopathy is effective in the treatment of upper respiratory tract infections in children, a frequent cause of inappropriate antibiotic prescribing. The EU recommends the use of homeopathy in organic animal husbandry, and it is used by significant numbers of farmers. At present there is little data on the effectiveness of homeopathy in this setting. Further research should be done.

Animals↗
PubMed2002

Homeopathy: what is it and is it of value in the care of patients with cancer?

The underlying principles of homeopathy include treating 'like with like' by remedies which are potentized by serial dilution and succussion. These distinguish homeopathy from other forms of alternative or complementary therapy. Conventional scientific wisdom dictates that homeopathy should have no effect above and beyond placebo but experiments on ultra-high dilutions of solutes together with some clinical data suggest the intriguing possibility that it might do in some circumstances. However, most clinical evidence comes from treating relatively minor self-limiting diseases and little comes from treating life-threatening disorders such as cancer. This paper explains the principles of homeopathy and reviews the data on its use in cancer care.

Homeopathy↗
PubMed2001

Using homeopathy for treating childhood asthma: understanding a family's choice.

The incidence and severity of asthma are increasing despite concerted efforts in comprehensive management. Families may be expected to look to complementary or alternative therapies (CAM) for help in treating persistent childhood asthma. One such therapy is homeopathy, a system of medicine that uses specially prepared, highly dilute substances to induce the body's self-healing in a comprehensive manner. This article describes the contrasting experiences for a family who undergoes specialty consultations with an allergist and with a homeopath. The style of the interview and the diagnostic tools used vary, as well as the basic philosophies and goals. The advantages and limitations, as well as the regulatory framework of homeopathy are explained, as evidenced by the literature. For nurses and other clinicians caring for children and families who use nonconventional therapies, the clinical implications are that these professionals need to become knowledgeable about the various alternative therapies which can complement conventional care. Families who wish to try homeopathy along with conventional care need to have open lines of communication and cooperation between their providers, both conventional and homeopathic. The care of childhood asthma may prove to benefit from clinical trials in homeopathy.

Adult↗
PubMed2000

Effects of acupuncture and homeopathy: prospective documentation. Interim results.

OBJECTIVE: To evaluate the overall effectiveness in general practice of homeopathy and acupuncture, and to estimate costs. METHOD: Prospective documentation of all patients insured with an insurance company who are provided with free treatment of acupuncture and homeopathy. 4000 patients treated by acupuncture and 1000 patients by homeopathy will be enrolled. All patients will be followed up from the beginning of treatment for another 4 years. Doctors will provide data on each visit (diagnosis, treatment, change of symptoms, etc.), patients will fill in questionnaires at the beginning and at the end of treatment, as well as each year after the end of treatment (complaints, current treatment, general health status as measured by the MOS-SF 36). Insurance data on workdays lost will be provided by the insurance company. RESULTS: Data acquisition and entry is continuing. Up to now data from the first questionnaire of 1453 patients have been entered and 951 patients have returned the follow-up questionnaire. Doctors' ratings of the change of the main diagnosis shows improvement of around 80% with only 2% deteriorated. This impression is vindicated by the patients' follow-up questionnaire. 36% patients rated the therapy as efficacious, 47% as partially efficacious. Quality of life as measured by the SF 36 questionnaire improved significantly in all dimensions. Data on workdays off will be presented. CONCLUSION: Homeopathy and acupuncture are clinically effective in a variety of medical problems.

Acupuncture Therapy↗