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Measurement Is the Key to Knowledge: Registration in Homeopathic Practice
05 February 2018 (online)
Background: Peoples’ mean number of years with chronic diseases has increased significantly in the past decades. Observational research has revealed that patients who seek homeopathic treatment often have long-term illnesses. Practice-based registration could inform us about chronicity, co-morbidity, reasons for consulting a homeopath and changes of complaints. Identification of “best homeopathic cases” in a database could improve homeopathic practice.
Objectives: To investigate the feasibility of registration in daily homeopathic practice, to evaluate patient reported outcome measures (PROMs) and tools for identifying “best homeopathic cases.”
Methods: Starting April 2015, 25 homeopathic doctors registered details of a maximum of 20 patients each, with 6 months follow-up per patient (extended follow-up for “best homeopathic cases”), in an Excel sheet or in the Homeopathic Administration and Registration Program (HARP). Informed consent was obtained from each patient. PROMs were: general health on a 0 to 100 VAS scale and change of main complaint on a 7-point Likert scale. “Best homeopathic cases” were defined by: treatment with one homeopathic medicine only, ≥2 months follow-up, result score +2 to +4 on a 9-point Likert scale by the doctor and changes could be attributed to the homeopathic medicine.
Results: Three hundred and ninety-nine patients were included. 43.1% wanted homeopathic treatment because conventional treatment had been ineffective. In 49.1%, the main complaint had been present for ≥2 years. Most common main diagnosis was “fatigue” (n = 56; 14%). Major improvement in main complaint (score +3) was reported by 22% to 26% at consecutive follow-up visits. Mean general health scores improved (13.1–18.6%). One hundred and ninety-five patients were treated with a single homeopathic medicine. Sixty-six “best homeopathic cases” were identified, 14 with psychological complaints (including sleep) as a main diagnosis, 10 with “fatigue” and 11 with respiratory tract complaints.
Conclusion: Registration of (co-)diagnoses, chronicity, treatments, and outcomes in homeopathic practice, with specific identification of “best homeopathic cases” using the defined criteria, is feasible.
Keywords: Homeopathy, registration, best practice, PROMs, comorbidity, patient motives, chronic complaints