Homeopathic Care Research

Overview of homeopathic health care research

"Studies that investigate the efficacy and safety of medicines under everyday conditions and with everyday patients are important for homeopathy research.

Although randomised controlled trials (RCTs) are considered the "gold standard" in clinical research, they have disadvantages: they are usually conducted at selected research centres, by selected doctors and with selected, usually recruited patients.

In many cases, it turns out years later under everyday conditions that the drugs are administered to other patients in a different context and with other concomitant diseases and drugs than in the authorisation studies, with different outcomes and sometimes also adverse effects. Research results from RCTs are therefore only transferable to everyday clinical practice to a limited extent.

For this reason, supplementary studies that investigate the efficacy and safety of drugs under everyday conditions and with everyday patients are important and are increasingly being called for. These clinical studies, which take place under everyday conditions, are referred to as "health care research". (Teut, 2016; transl. by the author)

International studies on health care research (HRI)

The following compilation is based on the publication of the Homeopathic Research Institute (HRI) (Observational Studies on Homeopathy, 2018). All links to the relevant papers can also be accessed via our archive. Further information on health care research can also be found directly on the HRI website: https://www.hri-research.org/resources/essentialevidence/observational-studies/

Great Britain

Five published studies conducted since 1999 to date have assessed the outcomes of patients treated in homeopathically orientated National Health Care hospitals:

Liverpool Department of Homeopathic Medicine (2001)

The Liverpool Department of Homeopathic Medicine (LDHM) conducted a survey of 1,100 patients over twelve months in 1999-2000 to assess treatment outcomes (Richardson, 2001).

76.6% reported that their health status had improved since starting homeopathic treatment. 60.3 % even found that it had improved substantial. 814 patients received conventional medical treatment at the same time; of these patients, 424 (52%) were able to reduce or completely discontinue conventional medication

Royal London Homeopathic Hospital (2003)

A survey of 500 patients at the Royal London Homeopathic Hospital (RLHH) showed that many patients were able to reduce or even stop taking conventional medication following homeopathic treatment. (Sharples et al., 2003)

Bristol Homeopathic Hospital (2005)

An observational study at Bristol Homeopathic Hospital included more than 6,500 consecutive patients with over 23,000 patient visits over a six-year period (Spence et al., 2005).

70 % of the patients examined reported that their health status had improved; 50 % even categorised the improvement as substantial. This was most pronounced in the case of childhood eczema or asthma as well as inflammatory bowel disease, irritable bowel syndrome, menopausal symptoms and migraines.

Bristol, Glasgow, Liverpool, London and Tunbridge Wells (2008)

In this pilot study, data from 1,602 patient follow-up appointments were collected and summarised for one month at all five National Health care homeopathy hospitals (E. A. Thompson et al., 2008).

At their second homeopathic appointment, 34% of patients who were followed up reported an improvement that had a positive impact on their daily lives. At the sixth appointment, the corresponding improvement rate was 59%. The five most frequently mentioned conditions included eczema, chronic fatigue syndrome, menopausal symptoms, osteoarthritis and depression.

Bristol Homeopathic Hospital (2016)

This study carried out in 2016 at Bristol Homeopathic Hospital as part of an audit of almost 200 patients confirmed the results of the 2005 study (see above). It proved that the state of health of chronically ill patients receiving homeopathic treatment improved statistically significantly. (E. Thompson et al., 2016)

Economic evaluations of homeopathy: Review (2014)

In 2014, the cost-effectiveness of homeopathy was analysed in a systematic review (Viksveen et al., 2014).

In 8 of 14 identified studies, an improvement in patients' symptoms and/or health status was found in conjunction with cost savings. In four studies, clinical outcomes were either better or equal with homeopathic treatment compared to a conventionally treated control group at similar costs.

Despite promising evidence of the potential benefits of homeopathy at lower costs, the studies were very heterogeneous and often had methodological flaws. Recommendations for future research are given.

France

The EPI3 project (2008-2012)

Homeopathy is widely used in France. The effectiveness of homeopathic treatments was assessed in a large-scale study involving 8,559 patients from GP practices. The "EPI3 study" (Grimaldi-Bensouda et al., 2011) is led by LA-SER, a UK-based company specialising in scientific evidence for medical and healthcare technologies (http://www.la-ser.com/). The project team includes people from high calibre institutions such as the Institut Pasteur in Paris, the University of Bordeaux and McGill University in Montreal; Lucien Abenhaim is the French Director General of Health. The most important results of the EPI3 project at a glance:

Upper respiratory tract infections (URTI)

Patients who were treated by homeopathically trained general practitioners performed just as well clinically as those who received purely conventional medical treatment. However, they managed with less conventional medication (Grimaldi-Bensouda et al., 2014).

Diseases of the musculoskeletal system

Patients treated with homeopathy did just as well clinically as those treated with conventional medicine, but took only half as many non-steroidal anti-inflammatory drugs (NSAIDs) and suffered fewer NSAID-related side effects (Rossignol et al., 2012).

Sleep, anxiety and depressive disorders

Patients treated by homeopathic physicians were less likely to be prescribed psychotropic drugs (Grimaldi-Bensouda et al., 2012).

Economic impact of homeopathic practice in general medicine in France (2015)

Data from the cross-sectional study EPI3 La-Ser were used to analyse consultation, prescription and total costs (consultation + prescription) of homeopathic treatment (Colas et al., 2015).

For each cost type, the costs for health insurance/social insurance, for the patient or supplementary insurance and the total health expenditure (sum of both expenditures) were analysed.

The summary shows that treatment by homeopathic general practitioners may be less cost-intensive and could therefore be of interest to the public health system.

Germany

Comparison of homeopathic and conventional medical care (2005)

A study commissioned by a German health insurance company to decide on the continued reimbursement of homeopathic treatments examined the benefits of homeopathy for the treatment of chronic conditions commonly encountered in GP practices. 9,493 patients (315 adults, 178 children) were treated either conventionally or homeopathically by general practitioners. According to the study, the health of patients in the homeopathy group improved more significantly than that of the conventional medicine group (p = 0.002); there were no significant differences in terms of costs. (C. Witt et al., 2005)

8-year follow-up of chronically ill patients undergoing homeopathic treatment (2008)

In this study, more than 3,500 adults and children who received routine homeopathic care from general practitioners were followed up (C. M. Witt et al., 2008).

It showed that patients who seek homeopathic treatment often experience clear improvement.

" At the start, 97% of participants were diagnosed with a chronic complaint, with 95% declaring prior conventional treatment for their condition. Disease severity decreased significantly (p < 0.001) between the start of the study, after 2 years and after 8 years of homeopathic treatment. Notably, after 8 years, figures were almost identical to 2-year follow-up, indicating steady long-term health benefits." (Observational Studies on Homeopathy , 2018)

Homeopathic Medical Practice: Long-term results of a cohort study with 3981 patients (2005)

The severity of the disease and the quality of life showed clear and lasting improvements after the homeopathic treatment phase. The results indicate that homeopathic medical therapy can play a positive role in the long-term care of patients with chronic diseases. (C. Witt et al., 2005)

Political dimensions: Cost-benefit analysis of homeopathic medicines

"Critics of homeopathy claim that the reimbursement of the procedure by the statutory health insurers represents a serious and unjustified burden on our healthcare system. It should therefore be discontinued: Homeopathy is proven to be ineffective and the money saved could be better spent on other, supposedly effective services. However, the majority of scientific studies on this topic show that homeopathy is at least as effective as conventional medicine with fewer side effects, while at the same time saving costs." (Behnke, Carstens Stiftung / Natur und Medizin e.V., 2019; transl. by the author]

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Sources and References

• Behnke, J. (2019, January 17). Faktencheck zu „Homöopathie und die gesetzliche Krankenversicherung“. Natur und Medizin e.V. / Carstens-Stiftung. Accessed on 4 August 2022 from https://www.naturundmedizin.de/homoeopathie-und-die-gesetzliche-krankenversicherung
• Colas, A., Danno, K., Tabar, C., Ehreth, J., & Duru, G. (2015). Economic impact of homeopathic practice in general medicine in France. Health Economics Review, 5(1), 18. https://doi.org/10.1186/s13561-015-0055-5
• Grimaldi-Bensouda, L., Begaud, B., Lert, F., Rouillon, F., Massol, J., Guillemot, D., Avouac, B., Duru, G., Magnier, A.-M., Rossignol, M., Abenhaim, L., & for the EPI3-LA-SER Group. (2011). Benchmarking the burden of 100 diseases: Results of a nationwide representative survey within general practices. BMJ Open, 1(2), e000215. https://doi.org/10.1136/bmjopen-2011-000215
• Grimaldi-Bensouda, L., Bégaud, B., Rossignol, M., Avouac, B., Lert, F., Rouillon, F., Bénichou, J., Massol, J., Duru, G., Magnier, A.-M., Abenhaim, L., & Guillemot, D. (2014). Management of Upper Respiratory Tract Infections by Different Medical Practices, Including Homeopathy, and Consumption of Antibiotics in Primary Care: The EPI3 Cohort Study in France 2007–2008. PLoS ONE, 9(3), e89990. https://doi.org/10.1371/journal.pone.0089990
• Grimaldi-Bensouda, L., Engel, P., Massol, J., Guillemot, D., Avouac, B., Duru, G., Lert, F., Magnier, A.-M., Rossignol, M., Rouillon, F., Abenhaim, L., Begaud, B., & for the EPI3-LA-SER group. (2012). Who seeks primary care for sleep, anxiety and depressive disorders from physicians prescribing homeopathic and other complementary medicine? Results from the EPI3 population survey. BMJ Open, 2(6), e001498. https://doi.org/10.1136/bmjopen-2012-001498
• Observational studies on homeopathy (2018). (2018). HRI Homeopathy Research Institute. Accessed on 6 September 2022 from https://www.hri-research.org/wp-content/uploads/2018/09/Observational-studies-of-homeopathy-Sept-2018.pdf
• Richardson, W. (2001). Patient benefit survey: Liverpool Regional Department of Homoeopathic Medicine. British Homeopathic Journal, 90(03), 158–162. https://doi.org/10.1054/homp.1999.0482
• Rossignol, M., Begaud, B., Engel, P., Avouac, B., Lert, F., Rouillon, F., Bénichou, J., Massol, J., Duru, G., Magnier, A., Guillemot, D., Grimaldi‐Bensouda, L., Abenhaim, L., & for the EPI3‐LA‐SER group. (2012). Impact of physician preferences for homeopathic or conventional medicines on patients with musculoskeletal disorders: Results from the EPI3‐MSD cohort. Pharmacoepidemiology and Drug Safety, 21(10), 1093–1101. https://doi.org/10.1002/pds.3316
• Sharples, F. M. C., Van Haselen, R., & Fisher, P. (2003). NHS patients’ perspective on complementary medicine: A survey. Complementary Therapies in Medicine, 11(4), 243–248. https://doi.org/10.1016/S0965-2299(03)00107-9
• Spence, D. S., Thompson, E. A., & Barron, S. J. (2005). Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. The Journal of Alternative and Complementary Medicine, 11(5), 793–798. https://doi.org/10.1089/acm.2005.11.793
• Teut, M. (2016). Versorgungsforschung zur Homöopathie. First published in ‘Der aktuelle Stand der Forschung zur Homöopathie’, WissHom, Köthen (Anhalt), 2016. Accessed on 4 August 2022 from https://www.carstens-stiftung.de/artikel/versorgungsforschung-zur-homoeopathie.html
• Thompson, E. A., Mathie, R. T., Baitson, E. S., Barron, S. J., Berkovitz, S. R., Brands, M., Fisher, P., Kirby, T. M., Leckridge, R. W., Mercer, S. W., Nielsen, H. J., Ratsey, D. H. K., Reilly, D., Roniger, H., & Whitmarsh, T. E. (2008). Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals. Homeopathy, 97(3), 114–121. https://doi.org/10.1016/j.homp.2008.06.005
• Thompson, E., Viksveen, P., & Barron, S. (2016). A patient reported outcome measure in homeopathic clinical practice for long-term conditions. Homeopathy, 105(4), 309–317. https://doi.org/10.1016/j.homp.2016.05.001
• Viksveen, P., Dymitr, Z., & Simoens, S. (2014). Economic evaluations of homeopathy: A review. The European Journal of Health Economics, 15(2), 157–174. https://doi.org/10.1007/s10198-013-0462-7
• Witt, C., Keil, T., Selim, D., Roll, S., Vance, W., Wegscheider, K., & Willich, S. N. (2005). Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. Complementary Therapies in Medicine, 13(2), 79–86. https://doi.org/10.1016/j.ctim.2005.03.005
• Witt, C. M., Lüdtke, R., Baur, R., & Willich, S. N. (2005). Homeopathic medical practice: Long-term results of a cohort study with 3981 patients. BMC Public Health, 5(1), 115. https://doi.org/10.1186/1471-2458-5-115
• Witt, C. M., Lüdtke, R., Mengler, N., & Willich, S. N. (2008). How healthy are chronically ill patients after eight years of homeopathic treatment? – Results from a long term observational study. BMC Public Health, 8(1), 413. https://doi.org/10.1186/1471-2458-8-413

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Authors: glt | Rev.: TBD | Ed.: pz | last modified Sep. 6, 2022