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Auditing outcomes and costs of integrated complementary medicine provision-The importance of length of follow up

Centre for Complementary Healthcare & Integrated Medicine (CCHIM), Faculty of Health & Human Sciences, Thames Valley University, Walpole House, 4th Floor, 18-22 Bond Street, Ealing, London W5 5AA, UK.
Complementary Therapies in Clinical Practice 11/2006; 12(4):249-57. DOI: 10.1016/j.ctcp.2006.07.007
Source: PubMed

ABSTRACT A retrospective audit was carried out on 58 patients with chronic health problems who were referred by 22 general practitioners (GPs) for acupuncture, aromatherapy, homeopathy, massage and osteopathy, or a combination. Costs of GP consultations, prescriptions, secondary care referrals, and diagnostic tests from records of 33 of these patients were compared pre (24 months), during (mean 4.3 months) and post (mean 5.7 months) complementary medicine (CM) treatment. Patient centred outcome data included the Measure Yourself Medical Outcome Profile (MYMOP) and content analysis of patient and practitioner comments. Costs of GP consultations/patient/month were significantly higher during (20.10 pounds, p<0.001) and post (17.53 pounds, p<0.01) CM treatment compared with pre-treatment costs (11.27 pounds). Total prescription costs were not significantly higher during and post-treatment than pre-treatment. Prescription costs for referred conditions were lower during (2.26 pounds) and higher post-treatment (3.75 pounds) compared with costs pre-treatment (3.24 pounds). Pre- and post-treatment MYMOP scores indicated significant improvements in health and well-being. Longer follow up, is required in order to demonstrate significant cost savings related to CM provision. Cost comparisons with conventional medicine should consider quantitative and qualitative data to capture the wider benefits experienced by patients.

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    • "Previous health economic investigations comparing conventional care and CTs have commonly focused on different CTs in isolation. A recent review reported that 90% of economic evaluations in the fields of CT and integrative medicine (IM) between 2001 and 2010 targeted single CT interventions and that there was only one evaluation, a retrospective audit of patients with chronic health problems, that involved access to multiple CTs [10] [11]. Thus research targeting comprehensive IM services in conventional care settings, and testing them against conventional usual care models, is indeed scarce, especially when it comes to prospective randomized clinical trials of managing chronic conditions. "
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    • "Previous health economic investigations comparing conventional care and CTs have commonly focused on different CTs in isolation. A recent review reported that 90% of economic evaluations in the fields of CT and integrative medicine (IM) between 2001 and 2010 targeted single CT interventions and that there was only one evaluation, a retrospective audit of patients with chronic health problems, that involved access to multiple CTs [10] [11]. Thus research targeting comprehensive IM services in conventional care settings, and testing them against conventional usual care models, is indeed scarce, especially when it comes to prospective randomized clinical trials of managing chronic conditions. "
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    • "As a result, the literature on the cost-effectiveness of homeopathy is often based either on post-hoc analysis of past prospective studies [7] or on retrospective studies [8] or comparing the costs of homeopathic treatments in a group to the (estimated) cost of conventional drugs which otherwise would be prescribed for the observed subjects [9]. Fewer are prospective cohort studies that compare costeffectiveness of allopathic and homeopathic treatments. "
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