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Case report of two siblings with multi-morbidities receiving homeopathic treatment for one year

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... This also adds to the benefits of addon homoeopathy in children with different other clinical conditions such as acute otitis media [22], autism [23], and thrombocytopenia due to dengue [24]. An integrative paediatrics survey showed homoeopathy was preferred by 60% of the patients. ...
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Background and objectives: Acute encephalitis syndrome is a health burden to a populous country like India. It is characterized by a sudden onset of fever, altered sensorium with or without seizures, irritability, abnormal behaviour, or unconsciousness. This study aims to augment further evidence on the effects of add-on homeopathic treatment in reducing mortality and morbidity in children. Methods: This comparative retrospective study included children hospitalized with acute encephalitis syndrome between July 2016 to December 2016. We compared the parameters of children for whom decisions on Glasgow Outcome scale and Liverpool outcome score aided by add-on homeopathy against those of children from the same year when the add-on homeopathy was not used. All the children were on conventional supportive care and treatment tailored to each child. We also counted the days until the resumption of oral feeding and the length of hospital stay. Results: Ordinal regression analysis on analyses on 622 children (IH +CSC=329; IMP only=293) was done. Odds of a shift towards increased recovery were superior in the homeopathy-added group than in the IMP group without adjustment (crude OR 2·30, 95% CI 1·66 to 3·20; p=0·0001) and with adjustment (adjusted OR 3.38, 95% CI 2·38 to 4.81; p=0·0001). There was 14.8% less mortality and 17.4% more recovery in the add-on homeopathy group compared to CSC alone. Individualized homeopathic remedies commonly used were: Belladonna (n =238), Stramonium (n =17), Opium (n = 14), Sulphur (n=11) and Hyoscyamus niger (n = 7). Conclusion : This retrospective cohort study advocates for add-on homoeopathy in children suffering acute encephalitis which can produce notable improvements in terms of mortality and morbidity. Further studies in different settings are warranted.
Article
Background Multimorbidity, a prevailing trend in the primary care population of all ages, is a challenge for health care systems that are largely configured for single disease management. Homeopathy has shown competence in the management of chronic diseases, whether they occur as a single ailment or as a multimorbidity. Case History A 35-year-old female patient presenting with hemorrhoids, low back pain, hypothyroidism, fibroadenosis breasts (bilateral), and fibroid uterus was given homeopathic treatment for 33 months at Nandigama AYUSH Lifestyle Disorders Clinic, Andhra Pradesh. She was prescribed the homeopathic medicines Lachesis mutus and Thyroidinum at different time intervals based on the totality of symptoms. Results Following treatment, a reduction in the size of the uterine fibroid and complete regression of breast lumps in ultrasonography were noted. The modified Naranjo criteria total score was 10 out of 13. Further, significant improvement in symptoms and laboratory parameters, such as triiodothyronine (T3), tetra-iodothyronine (T4), and thyroid-stimulating hormone (TSH), indicated that a well-chosen homeopathic medicine may be beneficial in managing multimorbidity. Conclusion This case study reveals a positive role of homeopathic treatment in multimorbidity. More case studies and well-designed controlled should be used to further investigate homeopathic intervention in multimorbidity.
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Unlabelled: 20 consecutively enrolled children age 5-16 with Attention Deficit Hyperactivity Disorder (ADHD) received treatment by a homeopath (8 consultations and individualized remedies) for one year. Ten subsequently enrolled children received similar time and attention for 4 months. The study explored optimum treatment protocols; the effectiveness, deliverability and acceptability of treatment; and the feasibility of outcome measurement and recruitment. Parents completed Conners' Parent Rating Scale, Revised Long Version ( Cprs-r: L) every 4 months, from which DSMIV total scores were extracted; and Measure Your Own Medical Outcome Profile (MYMOP) every consultation. An interaction between time (baseline/4 months) and group (treatment/non-treatment) was found .756 F (1,28)=9.06, p=0.005. The intervention was associated with statistically significant improvements in treated children over the year: Cprs-r: L (t (18)=4.529, p≤0.000); MYMOP (t (18)=6.938, p≤0.000). Mean DSMIV total t scores decreased at each time point: baseline: 85 (SD 5.1); 4 months 76.2 (SD 10.9); and 12 months 71.5 (SD 12.77). Recruitment of control participants was problematic. Recruitment to treatment was feasible via ADHD support groups, charities, police support agencies and social services, not schools or NHS services. Attending appointments was problematic for some participants, but home visits did not improve uptake. The best venue was a familiar clinic. Some participants took medicines inappropriately, but generally taking homeopathic remedies was acceptable and well implemented. Cprs-r: L (80 items) was problematic for some parents. MYMOP was preferred by parents but not acceptable to stakeholders. In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD. Treatment by a homeopath was associated with sustained, increasing improvements and the intervention was acceptable to participants. More methodically rigorous research is warranted. "We recommend that future research in this area uses comparative effectiveness randomised controlled trial designs. We also recommend that these trials measure outcomes of relevance to stakeholder needs - the people and services who care for those with ADHD - parents, teachers and social workers and the criminal justice system".
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Background: the aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting. Methods: the study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (? 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy. Results: data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the primary outcome criterion was 1.40 (0.89–2.22) in children and 0.92 (0.63–1.34) in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic treatment both in children (p = 0.0488) and adults (p = 0.0001). Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C: 7.6%; H: 3.1%, p = 0.0032), whereas in children the occurrence of adverse drug reactions was not significantly different (H: 2.0%; C: 2.4%, p = 0.7838). Conclusion: in primary care, homeopathic treatment for acute respiratory and ear complaints was not inferior to conventional treatment
Article
Full-text available
20 consecutively enrolled children age 5–16 with Attention Deficit Hyperactivity Disorder (ADHD) received treatment by a homeopath (8 consultations and individualized remedies) for one year. Ten subsequently enrolled children received similar time and attention for 4 months. The study explored optimum treatment protocols; the effectiveness, deliverability and acceptability of treatment; and the feasibility of outcome measurement and recruitment. Parents completed Conners' Parent Rating Scale, Revised Long Version (CPRS-R:L) every 4 months, from which DSMIV total scores were extracted; and Measure Your Own Medical Outcome Profile (MYMOP) every consultation. An interaction between time (baseline/4 months) and group (treatment/non-treatment) was found .756 F (1,28) = 9.06, p = 0.005. The intervention was associated with statistically significant improvements in treated children over the year: CPRS-R:L (t (18) = 4.529, p ≤ 0.000); MYMOP (t (18) = 6.938, p ≤ 0.000). Mean DSMIV total t scores decreased at each time point: baseline: 85 (SD 5.1); 4 months 76.2 (SD 10.9); and 12 months 71.5 (SD 12.77). Recruitment of control participants was problematic. Recruitment to treatment was feasible via ADHD support groups, charities, police support agencies and social services, not schools or NHS services. Attending appointments was problematic for some participants, but home visits did not improve uptake. The best venue was a familiar clinic. Some participants took medicines inappropriately, but generally taking homeopathic remedies was acceptable and well implemented. CPRS-R:L (80 items) was problematic for some parents. MYMOP was preferred by parents but not acceptable to stakeholders. In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD. Treatment by a homeopath was associated with sustained, increasing improvements and the intervention was acceptable to participants. More methodically rigorous research is warranted. “We recommend that future research in this area uses comparative effectiveness randomised controlled trial designs. We also recommend that these trials measure outcomes of relevance to stakeholder needs – the people and services who care for those with ADHD – parents, teachers and social workers and the criminal justice system”.
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Recent meta-analyses of randomized controlled trials in homeopathy have suggested that homeopathy is more than a placebo response. Comparison of the effectiveness of homeopathy in primary care with conventional medicine in primary care for three commonly encountered clinical conditions. An international multicenter, prospective, observational study in a real world medical setting comparing the effectiveness of homeopathy with conventional medicine. Thirty (30) investigators with conventional medical licenses at six clinical sites in four countries enrolled 500 consecutive patients with at least one of the following three complaints: (1) upper respiratory tract complaints including allergies; (2) lower respiratory tract complaints including allergies; or (3) ear complaints. The primary outcomes criterion was the response to treatment, defined as cured or major improvement after 14 days of treatment. Secondary outcomes criteria were: (1) rate of recovery; (2) occurrence of adverse events; (3) patient satisfaction; and (4) length of consultation. Four hundred and fifty-six (456) patient visits were compared: 281 received homeopathy, 175 received conventional medicine. The response to treatment as measured by the primary outcomes criterion for patients receiving homeopathy was 82.6%, for conventional medicine it was 68%. Improvement in less than 1 day and in 1 to 3 days was noted in 67.3% of the group receiving homeopathy and in 56.6% of those receiving conventional medicine. The adverse events for those treated with conventional medicine was 22.3% versus 7.8% for those treated with homeopathy. Seventy-nine percent (79.0%) of patients treated with homeopathy were very satisfied and 65.1% of patients treated with conventional, medicine were very satisfied. In both treatment groups 60% of cases had consultations lasting between 5 and 15 minutes. Homeopathy appeared to be at least as effective as conventional medical care in the treatment of patients with the three conditions studied.
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The purpose of this paper is to explore the possibility that adverse reactions and drug interactions arising from the use of homeopathic and herbal medicines could lead to confusion when adverse reactions to conventional medicines are reported. An extensive literature review was conducted on the occurrence of adverse reactions and drug interactions following the use of homeopathic or herbal remedies, and the potential for these to confound adverse event reporting to conventional medicines considered. The survey demonstrates the potential for herbal remedies and homeopathic products, to produce adverse drug reactions or drug interactions, and shows the scope for potential for confusion with those arising from conventional medicines. There is a need for greater awareness that adverse reactions apparently due to a conventional medicine, might in reality be due to a herbal medicine or a drug interaction between a herbal medicine and a conventional drug, particularly when a health professional is unaware of the extent of a patient's self-medication with alternative therapies.
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The Health Technology Assessment report on effectiveness, cost-effectiveness and appropriateness of homeopathy was compiled on behalf of the Swiss Federal Office for Public Health (BAG) within the framework of the 'Program of Evaluation of Complementary Medicine (PEK)'. Databases accessible by Internet were systematically searched, complemented by manual search and contacts with experts, and evaluated according to internal and external validity criteria. Many high-quality investigations of pre-clinical basic research proved homeopathic high-potencies inducing regulative and specific changes in cells or living organisms. 20 of 22 systematic reviews detected at least a trend in favor of homeopathy. In our estimation 5 studies yielded results indicating clear evidence for homeopathic therapy. The evaluation of 29 studies in the domain 'Upper Respiratory Tract Infections/Allergic Reactions' showed a positive overall result in favor of homeopathy. 6 out of 7 controlled studies were at least equivalent to conventional medical interventions. 8 out of 16 placebo-controlled studies were significant in favor of homeopathy. Swiss regulations grant a high degree of safety due to product and training requirements for homeopathic physicians. Applied properly, classical homeopathy has few side-effects and the use of high-potencies is free of toxic effects. A general health-economic statement about homeopathy cannot be made from the available data. Taking internal and external validity criteria into account, effectiveness of homeopathy can be supported by clinical evidence and professional and adequate application be regarded as safe. Reliable statements of cost-effectiveness are not available at the moment. External and model validity will have to be taken more strongly into consideration in future studies.
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Full-text available
The aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting. The study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (< or = 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy. Data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the primary outcome criterion was 1.40 (0.89-2.22) in children and 0.92 (0.63-1.34) in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic treatment both in children (p = 0.0488) and adults (p = 0.0001). Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C: 7.6%; H: 3.1%, p = 0.0032), whereas in children the occurrence of adverse drug reactions was not significantly different (H: 2.0%; C: 2.4%, p = 0.7838). In primary care, homeopathic treatment for acute respiratory and ear complaints was not inferior to conventional treatment.
Article
Background The treatment of multimorbid patients who have a combination of three or more concurrent complaints is one of the core competencies of homeopathy. In this article we introduce the application of polarity analysis (PA) in multimorbidity. PA came to prominence through the Swiss homeopathic ADHD double-blind study, which successfully demonstrated a significant difference between highly dilute homeopathic remedies and placebo. PA enables homeopaths to calculate a relative healing probability, based on Boenninghausen's grading of polar symptoms. After its evaluation in the treatment of a variety of acute and chronic disease, which showed improved results compared to a conventional homeopathic approach, it was a challenge to test PA with multimorbid patients. Since such patients almost invariably have a multiple symptoms, the question was whether we can nevertheless successfully use Polarity Analysis or whether the method is rendered ineffective by the multitude of symptoms. Methods We treated 50 multimorbid patients with PA and prospectively followed them over one year. Results 43 patients (86%) completed the observation period, achieving an average improvement of 91% in their initial symptoms. Six patients dropped out, and one did not achieve an improvement of 80%, and was therefore also counted as a treatment failure. The cost of homeopathic treatment was 41% of projected equivalent conventional treatment. Conclusions Polarity Analysis is an effective method for treating multimorbidity. The multitude of symptoms does not prevent the method from achieving good results. Homeopathy may be capable of taking over a considerable proportion of the treatment of multimorbid patients, at lower costs than conventional medicine.
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A new programme of systematic reviews of randomised controlled trials (RCTs) in homeopathy will distinguish important attributes of RCT records, including: placebo controlled versus other-than-placebo (OTP) controlled; individualised versus non-individualised homeopathy; peer-reviewed (PR) versus non peer-reviewed (NPR) sources. (a) To outline the methods used to search and categorise the RCT literature; (b) to report details of the records retrieved; (c) to compare our retrieved records with those reported in two previous systematic reviews (Linde et al., 1997; Shang et al., 2005). Ten major electronic databases were searched for records published up to the end of 2011. A record was accepted for subsequent systematic review if it was a substantive report of a clinical trial of homeopathic treatment or prophylaxis in humans, randomised and controlled, and published in a PR or NPR journal. 489 records were potentially eligible: 226 were rejected as non-journal, minor or repeat publications, or lacking randomisation and/or controls and/or a 'homeopathic' intervention; 263 (164 PR, 99 NPR) were acceptable for systematic review. The 263 accepted records comprised 217 (137 PR, 80 NPR) placebo-controlled RCTs, of which 121 were included by, 66 were published after, and 30 were potentially eligible for, but not listed by, Linde or Shang. The 137 PR records of placebo-controlled RCTs comprise 41 on individualised homeopathy and 96 on non-individualised homeopathy. Our findings clarify the RCT literature in homeopathy. The 263 accepted journal papers will be the basis for our forthcoming programme of systematic reviews.
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In 2008, the number of poisoning deaths exceeded the number of motor vehicle traffic deaths and was the leading cause of injury death for the fi rst time since at least 1980. During the past three decades, the poisoning death rate nearly tripled, while the motor vehicle traffic death rate decreased by one-half. During this period, the percentage of poisoning deaths that were caused by drugs increased from about 60% to about 90%. The population groups with the highest drug poisoning death rates in 2008 were males, people aged 45–54 years, and non-Hispanic white and American Indian or Alaska Native persons. The vast majority of drug poisoning deaths are unintentional (see Appendix table). Opioid analgesics were involved in more drug poisoning deaths than other specified drugs, including heroin and cocaine. Opioid analgesics were involved in nearly 15,000 deaths in 2008, while cocaine was involved in about 5,100 deaths and heroin was involved in about 3,000 deaths (data not shown). Deaths involving opioid analgesics may involve other drugs as well, including benzodiazepines (2). In addition to an increase in the number of deaths caused by drug poisoning, increases in drug use, abuse, misuse, and nonfatal health outcomes have been observed. In the past two decades, there has been an increase in the distribution and medical use of prescription drugs, including opioid analgesics (3). From 1999 to 2008, the use of prescription medications increased (4). In 2007–2008, 48% of Americans used at least one prescription drug in the past month and 11% of Americans used five or more prescriptions in the past month. Analgesics for pain relief were among the common drugs taken by adults aged 20–59 years (4). In 2009–2010, over 5 million Americans reported using prescription pain relievers nonmedically in the past month (that is, without a doctor’s prescription or only for the experience or feeling they caused), and the majority of people using prescription pain relievers nonmedically reported getting the drugs from friends or family (5,6). From 2004 to 2008, the estimated rate of emergency department visits involving nonmedical use of opioid analgesics doubled from 49 per 100,000 to 101 per 100,000 (7). Government agencies and other organizations joined together to achieve great reductions in the number of deaths from motor vehicle crashes in the past three decades (8,9). A comprehensive approach, including improvements in the safety of vehicles; improvements in roadways; increased use of restraint systems, such as seat belts and child safety seats; reductions in speed; and also efforts to reduce driving under the influence of alcohol and drugs, contributed to the decline in motor vehicle related deaths (8,9). Using a comprehensive, multifaceted approach, it may be possible to reverse the trend in drug poisoning mortality.
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Adverse drug events (ADEs) are a common complication of medical care resulting in high morbidity and medical expenditure. Population level estimates of outpatient ADEs are limited. Our objective was to provide national estimates and characterizations of outpatient ADEs and determine risk factors associated with these events. Data are from the National Center for Health Statistics which collects information on patient visits to outpatient clinics and emergency departments throughout the United States. We examined visits between 1995 and 2005 and measured the national annual estimates of and risk factors for outpatient ADEs requiring medical treatment. The national annual number of ADE-related visits was 4 335,990 (95%CI: 4 326 872-4 345 108). Visits for ADEs to outpatient clinics increased over the study period from 9.0 to 17.0 per 1000 persons (p-value for trend < 0.001). In multivariate analyses, factors associated with ADE visits included patient age (OR: 2.13; 95%CI: 1.63-2.79 for 65 years and older), number of medications taken by patient (OR: 1.88; 95%CI: 1.58-2.25 for five medications or more), and female gender (OR: 1.51; 95%CI: 1.34-1.71). Overall, outpatient ADEs resulted in 107,468 (95%CI: 89 011-125 925) hospital admissions annually, with older patients at highest risk for hospitalization (p-value for trend < 0.001). Both patient age and polypharmacy use are risk factors for ADE-related healthcare visits, which have substantially increased in outpatient clinics between 1995 and 2005. The incidence of ADEs has particularly increased among patients 65 years and older with as many as 1 in 20 persons seeking medical care for an ADE.
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A retrospective observational study was conducted on 105 out of 233 patients suffering from chronic respiratory disease attending the Homeopathic Clinic of the Campo di Marte Hospital in Lucca (Tuscany, Italy) between October 1998 and May 2003. We assessed the cost of conventional medicinal products using Anatomic Therapeutic Chemical (ATC) classification, specific for the pathology in question, and the general costs in the year preceding the first appointment at the Homeopathic Clinic vs. the first and second year subsequent to homeopathic treatment. The costs of conventional drugs for a group of patients affected by asthma (8 patients) and recurrent respiratory infections (16 patients) with long term use of conventional medicine treated by homeopathy were compared with the expenses of conventional drugs of a matched group of 16 and 32 patients, respectively. Costs of pharmacological therapy specific for respiratory diseases were reduced by 46.3% (n=105) in the first year (P<0.01); and by 47.5% (n=72) in the second year (P<0.01) of homeopathic treatment. Reduction in general drug costs during homeopathic therapy was 42.4% in the first year (P<0.01); and -49.8 in the second year (N.S.). Costs for patients affected by chronic asthma showed a reduction in expenses of 71.1% for specific medicines relative to the group in homeopathic treatment vs. an increase of 12.3% in the group treated only with conventional drugs after the first year of follow-up and, respectively, a reduction of -54.4% for homeopathic treatment vs. +45.2% after the second year. For patients with recurrent respiratory infections we found a reduction of 35.8% in the homeopathic group in the first year, compared to an increase 8.6% of costs for specific drugs in the control group; in the second year the respective figures were -43.6% versus +7.8% in the control group. Homeopathic treatment for respiratory diseases (asthma, allergic complaints, Acute Recurrent Respiratory Infections) was associated with a significant reduction in the use and costs of conventional drugs. Costs for homeopathic therapy are significantly lower than those for conventional pharmacological therapy.
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To assess the sensitivity to within person change over time of an outcome measure for practitioners in primary care that is applicable to a wide range of illness. Comparison of a new patient generated instrument, the measure yourself medical outcome profile (MYMOP), with the SF-36 health profile and a five point change score; all scales were completed during the consultation with' practitioners and repeated after four weeks. 103 patients were followed up for 16 weeks and their results charted; seven practitioners were interviewed. Established practice of the four NHS general practitioners and four of the private complementary practitioners working in one medical centre. Systematic sample of 218 patients from general practice and all 47 patients of complementary practitioners; patients had had symptoms for more than seven days. Standardised response mean and index of responsiveness; view of practitioners. The index of responsiveness, relating to the minimal clinically important difference, was high for MYMOP: 1.4 for the first symptom, 1.33 for activity, and 0.85 for the profile compared with < 0.45 for SF-36. MYMOP's validity was supported by significant correlation between the change score and the change in the MYMOP score and the ability of this instrument to detect more improvement in acute than in chronic conditions. Practitioners found that MYMOP was practical and applicable to all patients with symptoms and that its use increased their awareness of patients' priorities. MYMOP shows promise as an outcome measure for primary care and for complementary treatment. It is more sensitive to change than the SF-36 and has the added bonus of improving patient-practitioner communication.
Article
To evaluate the safety of homeopathic medicines by critically appraising reports of adverse effects published in English from 1970 to 1995. Systematic review on information regarding adverse effects of homeopathic medicines identified using electronic databases, hand searching, searching reference lists, reviewing the bibliography of trials, and other relevant articles, contacting homeopathic pharmaceutical companies and drug regulatory agencies in UK and USA, and by communicating with experts in homeopathy. The mean incidence of adverse effects of homeopathic medicines was greater than placebo in controlled clinical trials (9.4/6.1) but effects were minor, transient and comparable. There was a large incidence of pathogenetic effects in healthy volunteers taking homeopathic medicines but the methodological quality of these studies was generally low. Anecdotal reports of adverse effects in homeopathic publications were not well documented and mainly reported aggravation of current symptoms. Case reports in conventional medical journals pointed more to adverse effects of mislabelled 'homeopathic products' than to true homeopathic medicines. Homeopathic medicines in high dilutions, prescribed by trained professionals, are probably safe and unlikely to provoke severe adverse reactions. It is difficult to draw definite conclusions due to the low methodological quality of reports claiming possible adverse effects of homeopathic medicines.
Article
Homeopathic aggravations have often been described anecdotally. However, few attempts have been made to scientifically verify their existence. This systematic review aimed at comparing the frequency of homeopathic aggravations in the placebo and verum groups of double-blind, randomised clinical trials. Eight independent literature searches were carried out to identify all such trials mentioning either adverse effects or aggravations. All studies thus found were validated and data were extracted by both authors. Twenty-four trials could be included. The average number of aggravations was low. In total, 50 aggravations were attributed to patients treated with placebo and 63 to patients treated with homoeopathically diluted remedies. We conclude that this systematic review does not provide clear evidence that the phenomenon of homeopathic aggravations exists.
Article
To evaluate the effectiveness of homoeopathy versus conventional treatment in routine care. Comparative cohort study. Patients with selected chronic diagnoses were enrolled in medical practice. Conventional treatment or homeopathy. Severity of symptoms assessed by patients and physicians (visual rating scale, 0-10) at baseline, 6 and 12 months and costs. The analyses of 493 patients (315 adults, 178 children) indicated greater improvement in patients' assessments after homoeopathic versus conventional treatment (adults: homeopathy from 5.7 to 3.2; conventional, 5.9-4.4; p=0.002; children from 5.1 to 2.6 and from 4.5 to 3.2). Physician assessments were also more favourable for children who had received homoeopathic treatment (4.6-2.0 and 3.9-2.7; p<0.001). Overall costs showed no significant differences between both treatment groups (adults, 2155 versus 2013, p=0.856; children, 1471 versus 786, p=0.137). Patients seeking homoeopathic treatment had a better outcome overall compared with patients on conventional treatment, whereas total costs in both groups were similar.
Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
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