An Overview of Positive Homeopathy Research and Surveys The European Network of Homeopathy Researchers November 2006 This document has been produced by the European Network for Homeopathy Researchers (ENHR). The ENHR was established in 2004 with support from the European Council for Classical Homeopathy (ECCH). ECCH currently assists the ENHR in its secretarial work. The ENHR consists of 55 individuals from 14 different countries involved in or with a special interest in homeopathy research. The ENHR is open to membership for any individual involved or interested in homeopathy research. Purpose of the European Network of Homeopathy Researchers (ENHR): •
The primary aim of the ENHR is to contribute to improving homeopathy research for the benefit of patients.
A long-term objective of the ENHR is to contribute to carrying out international EU funded research projects within the area of homeopathy research.
The ENHR consists of researchers, research advisors and representatives of the homeopathy profession as well as consumer/patient groups with an interest in the area of homeopathy research.
Members of the ENHR inform each other about homeopathy research that is in the planning stages or being carried out, as well as published research articles.
Introduction This document contains a sample of brief summaries of positive homeopathy research, together with the full references. Additional information may be found in the document entitled 'Facts about homeopathy and other CAM therapies’ (an ECCH document), and on the enclosed list of website addresses. Readers are recommended to read the full research articles in order to acquire a more profound knowledge base of research that has been undertaken. Contents
Use of homeopathy and other CAM therapies
User surveys showing patient satisfaction with homeopathic treatment
Hay fever, asthma and perennial rhinitis
Basic research – The effect of high dilutions
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 USE OF HOMEOPATHY AND OTHER CAM THERAPIES
Homeopathy is being practised in 41 out of 42 European countries. The Legal Situation for the Practice of Homeopathy in Europe, revised report, May 2006, European Council for Classical Homeopathy. Legal Status of Traditional Medicine and Complementary/ Alternative Medicine: A Worldwide Review, World Health Organization, 2001.
Homeopathy is the most frequently used CAM therapy in 5 out of 16 surveyed countries in Europe and among the three most frequently used in 11 out of 16 surveyed countries. Norges offentlige utredninger, NOU 1998:21 Alternativ medisin. (Official report published by the Norwegian Department of Health. Available at: http://odin.dep.no/hd/norsk/publ/utredninger/NOU/030005-020019/index-ved005-b-n-a.html) Ot.prp. nr. 27 (2002-2003). Om lov om alternativ behandling av sykdom mv.
Public interest in, and acceptance of alternative treatment increases in most European countries. Percentage of the population using alternative treatment varies from 18 to 71 % depending on country. Ot.prp. nr. 27 (2002-2003). Om lov om alternativ behandling av sykdom mv. Det kongelige
Homeopathy is officially recognised and included in the national health system in a number of countries within and outside of Europe. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, 2001.
Three Europeans out of four know about homeopathy and of these 29 % use it for their health care. Homeopathic medicinal products. Commission report to the European Parliament and the Council on the application of Directives 92/73 and 92/74. A study of 1097 patients visiting 80 Norwegian homeopaths showed that one in four patients were children between 0 and 9 years of age, compared to one in ten in 1985 and in general practice. The most commonly presented complaints were respiratory, skin and psychological complaints. Steinsbekk A, Fønnebø V. Users of homeopaths in Norway in 1998, compared to previous users and GP patients. Homeopathy (2003) 92, 3-10.
A survey of 1400 patients treated in a homeopathic clinic showed that 36 % were under the age of 16 in 2004, compared to 26 % in 1995. Respiratory complaints, complaints of ears and skin accounted for 70 % of patients in the age group from 0 to 10 years. More than half of the patients had university or other higher education. Viksveen P, Steinsbekk A. Changes in patients visiting a homeopathic clinic in Norway from 1994 to 2004. Homeopathy (2005) 94, 222-228. A survey of more than 70 000 citizens showed that approximately 9 million people in Italy (15.6 % of the population) have used at least one unconventional therapy in the period from 1997 to 1999. Homeopathy was the most frequently used (8.2 % of the population). Homeopathy was also quite commonly used by children (7.7 %). The use of CAM therapies has almost doubled since 1991. Menniti-Ippolito, F., Forcella, E., Bologna, E., Gargiulo, L., Traversa, G., & Raschetti, R. Use of unconventional medicine in children in Italy. Eur J Clin Pharmacol 2002 Apr;58(1):61-4.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 USER SURVEYS SHOWING PATIENT SATISFACTION WITH HOMEOPATHIC TREATMENT
In an observational study of 6544 consecutive patients during a 6-year period, and over 23,000 consultations, results showed that 70.7 % reported positive health changes, with 50.7 % recording their improvement as better (+2) or much better (+3). Of the 1270 children that were treated 80.5 % had some improvement, and 65.8 % were better (+2) or much better (+3). Spence DS, Thompson EA, Barron SJ. Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. The Journal of Alternative and Complementary Medicine. Volume 11, Number 5, 2005, pp. 793-798.
In a prospective, multi-centre cohort study with 103 primary care practices treating 3981 patients, disease severity decreased significantly (p<0.001) over a 2 year period. Major improvements were observed for quality of life for adults and young children. 28 % (1130) of the patients were children and 97 % of all diagnoses where chronic with an average duration of 8.8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Witt CM, Luedtke R, Baur R, Willich SN. Homeopathic Medical Practice: Long-term results of a Cohort Study with 3981 Patients. BMC Public Health 2005, 5:115.
Seven out of ten patients visiting Norwegian homeopaths reported a meaningful improvement in their main complaint 6 months after the initial consultation. Steinsbekk, A. Patients' assessments of the effectiveness of homeopathic care in Norway: A prospective observational multi-centre outcome study. Homeopathy, Volume 94, Issue 1, January 2005, Pages 10- 16.
One year after their first visit to a homeopathic clinic, 609 patients were asked to rate their general health compared with a year ago. 73.5 % reported a marked or moderate improvement in their health status. F. Attena et al. Homeopathy in Primary Care: self reported change in health status. Complementary therapies in Medicine Vol 8 No 1. March 2000.
A study of 829 patients treated with homeopathic medicines, where conventional treatment had been unsatisfactory or contraindicated. 61 % had a substantial improvement with homeopathy. Sevar, R. Audit of outcome in 829 consecutive patients treated with homeopathic medicine. British Homeopathic Journal Vol 89 No.4. Oct 2000.
A survey of more than 900 patients treated homeopathically showed substantial improvement in quality of life over the first 6 months after treatment and this effect remained more or less stable over the following years. Güthlin C, Lange O and Walach H. Measuring the effects of acupuncture and homoeopathy in general practice: An uncontrolled prospective documentation approach. BMC Public Health 2004, 4:6.
British prospective survey of homeopathic treatment of 223 patients, 1996. 90% improvement or more: 32%. 60% improvement or more: 65% 50% improvement or more: 72%. Report on NHS practice-based homoeopathy project. Analysis of effectiveness and cost of homoeopathic treatment within a GP practice at St. Margaret's Surgery, Bradford on Avon, Wilts. Elizabeth A Christie, Andrew T Ward ISBN 1 901262 006
British prospective survey of homeopathic treatment of 160 patients, 1994. Very positive effect: 73%. Some effect: 27%. No effect: 0%. Report on a Homoeopathy Project in an NHS Practice. Covering 18 month period from February 1993 to August 1994. Elizabeth A Christie, Andrew T Ward,. Reprinted February 1997.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006
British prospective survey of homeopathic treatment of 37 patients suffering from psychological complaints, 1998. Very satisfied: 81%. Satisfied: 16%. Not satisfied at all: 3%. Homoeopathy within the NHS. Evaluation of homoeopathic treatment of common mental health problems. 1995 - 1997. Alistair Dempster,. Rydings Hall Surgery, Brighouse, West Yorkshire. ISBN No 1901262014.
Retrospective survey of homeopathic treatment, Danmarks Farmaceutiske Højskole, 1995. 73% of patients stated they improved after homeopathic treatment. Andersen HE, Eldov P. Klassisk homøopati - og dens brugere. Institut for Samfundsfarmaci, Danmarks Farmaceutiske Højskole. 1995. Andersen, Helle Egebjerg. En undersøgelse af Klassisk Homøpati. Teorier, praksis og brugererfaringer. 1999. ISBN 87-987279-0-7
The effect of homeopathy, acupuncture and osteopathy. Result: 89% of patients stated they experienced positive effect from the treatment. Particularly clear effect on reduction of pain, increased vitality, ability to function socially and with regards to limitations at work and in daily activities influenced by physical problems. Homeopathy was particularly effective for patients suffering from arthritis, hay fever, asthma and skin complaints. Richardson J. Quasi-randomised control trial to assess the outcome of acupuncture, osteopathy and homoeopathy using the short form 36 item health survey. Health Services Research and Evaluation Unit, The Lewisham Hospital NHS Trust. December 1996.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 REVIEWS AND META-ANALYSES
A meta-analysis is a means of combining results from more than one trial to look for overall trends. (NB! In general complicated research terminology such as OR, CI, and words such as significant or randomized should only be used in communications with people who will understand such terminology. Otherwise stick to what can be understood by all, e.g. a survey of all the high quality research that has been carried out clearly shows that homeopathy is effective.) Results were found in favour of homeopathy in 20 of 22 systematic reviews on the effect of homeopathic high-potencies on cells or living organisms. For upper respiratory tract infections and allergies six out of seven studies were in favour of homeopathy. The authors of this article concluded that the effectiveness of homeopathy can be supported by clinical evidence and treatment is safe. The article has been published by authors who took part of the Program for Evaluation of Complementary Medicine (PEK), the same program which in August 2005 resulted in the publication of an article by Shang et al, where the conclusion was that the effect of homeopathy is placebo. Bornhöft et al. Effectiveness, Safety and Cost-Effectiveness of Homeopathy in General Practice – Summarized Health Technology Assessment. Forsch Komplementärmed 2006;13(suppl 2):19-29.
In a review of homeopathy research the authors found three independent systematic reviews of placebo-controlled trials on homeopathy that reported effects that seem to be more than placebo, and one review that found its effects consistent with placebo. Jonas, W. B., Kaptchuk, T. J., & Linde, K. 2003b, "A critical overview of homeopathy", Ann.Intern.Med., vol. 138, no. 5, pp. 393-399.
A systematic review and meta-analysis showed highly significant results for surveys adding up to a total of 2 617 patients (P=0.000036). Results were not that significant for high quality surveys (P=0.08). The author concludes that further high quality studies are needed to confirm results. Cucherat, M., Haugh, M. C., Gooch, M., & Boissel, J. P. 2000, "Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group", Eur.J.Clin.Pharmacol., vol. 56, no. 1, pp. 27-33.
A systematic review of results from 93 substantive RCTs was carried out by Robert Mathie (2003). It concludes that of the 35 different medical conditions covered by these trials the weight of evidence favours a positive treatment effect in 8: childhood diarrhoea, fibrositosis, hay fever, influenza, pain (miscellaneous), side-effects of chemotherapy or radiotherapy, sprains and upper-respiratory tract infections. Mathie, R. The research evidence base for homeopathy: a fresh assessment of the literature. Homeopathy 92: 84-91. 2003.
Meta-analysis of 89 trials of homeopathic medicine versus placebo. Result: significantly in favour of homeopathy (OR 2,45 (95% CI 2,05-2,93)). This meta-analysis included 186 placebo-controlled studies of homeopathy published until mid-1996, of which data for analysis could be extracted from 89. The overall odds ratio was 2.45 (95% confidence intervals 2.05-2.93) in favour of homeopathy, which means that the chances that homeopathy would benefit the patient were 2.45 times greater than placebo. When considering just those trials of high quality published in MEDLINE listed journals, and with predefined primary outcome measures, the pooled odds ratio was 1.97 and significant. Even after correction for publication bias the results remained significant. The main conclusion was that the results "were not compatible with the hypothesis that the effects of homeopathy are completely due to placebo". If the result of new trials were to show no difference between homeopathy and placebo, we would have to add 923 trials with no effect with 118 patients in each in order to balance the two. Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997;350:834-43.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 REVIEWS ANDMETA-ANALYSES
HMRG report with overview of clinical research in homeopathy, identified 184 controlled clinical trials. They selected the highest quality randomized control trials, which included a total of 2617 patients for a meta-analysis. This meta-analysis resulted in a p-value of 0.000036 (which means that results are highly significant) indicating that homeopathy is more effective than placebo. The researchers concluded that the "hypothesis that homeopathy has no effect can be rejected with certainty". Homeopathic Medicine Research Group. Report to the European Commission directorate general XII: science, research and development. Vol 1 (short version). Brussels: European Commission, 1996:16-7.
Of the 105 trials with interpretable results, 81 trials indicated positive results. Most studies showed results in favour of homeopathy even among those randomized controlled trials that received high- quality ratings for randomization, blinding, sample size, and other methodological criteria. They came to the following conclusion: "The amount of positive evidence even among the best studies came as a surprise to us. Based on this evidence we would readily accept that homeopathy can be efficacious, if only the mechanism of action were more plausible. The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications". Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of homoeopathy. British Medical Journal. 1991b;302:316-23.
A health technology assessment report on effectiveness, cost-effectiveness and appropriateness of homeopathy was compiled on behalf of the Swiss Federal Office for Public Health. Results showed a positive overall result in favour of homeopathy in 29 studies on upper respiratory tract infections and allergic reactions. Results also showed 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 favour of homeopathy. Boarnhoft G, Wolf U, Ammon K, Righetti M, Maxion-Bergemann S, Baumgartner S, Thurneysen AE, Matthiessen PF. Effectiveness, safety and cost-effectiveness of homeopathy in general practice – summarized health technology assessment. Forsch Komplementarmed. 2006; 13 Suppl 2: 19-29.
A meta-analysis of three trials on homeopathic immunotherapy. Result: significant effect in favour of homeopathic treatment. Reilly D, Taylor MA, Beattie NGM, Campbell JH, McSharry C, Aitchison TC, Carter R, Stevenson RD. Is evidence for homoeopathy reproducible? Lancet. 1994;344:1601-1606.
A review of placebo-controlled clinical trials using homeopathic medicines to treat people with AIDS or who are HIV-positive found 5 controlled clinical trials. Results showed statistically significant results in subjects with stage III AIDS, and specific physical, immunologic, neurologic, metabolic, and quality-of-life benefits, including improvements in lymphocyte counts and functions and reductions in HIV viral loads in patients receiving homeopathic treatment. Ullman D. Controlled Clinical Trials Evaluating the Homeopathic Treatment of People with Human Immunodeficiency Virus or Acquired Immune Deficiency Syndrome. The Journal of Alternative and Complementary Medicine. Volume 9, Number 1, 2003, pp. 133-141.
Meta-analysis of 105 articles on laboratory research. Result: positive effect 50% more frequently than negative effect among trials of highest methodological quality. (1994) Linde K. Jonas WB, Melchart D, Worku F, Wagner H, Eital F. Critical Review and Meta-Analysis of Serial Agitated Dilutions in Experimental Toxicology. Human and Experimental Toxicology. 1994;13:481-492.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS
Diarrhoea in children Treatment of acute childhood diarrhoea in Nicaragua This trial involved 81 children aged from 6 months to 5 years in a randomised, double-blind trial of intravenous fluids plus placebo versus intravenous fluids plus homeopathic remedy individualised to the patient. The treatment group had a statistically significant decrease in duration of diarrhoea. Jacobs J. Treatment of acute childhood diarrhoea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics 1994; 93: 719-725. Treatment of acute childhood diarrhoea, repeated in Nepal In a replication of a trial carried out in Nicaragua in 1994, 116 Nepalese children aged 6 months to 5 years suffering from diarrhoea were given an individualised homoeopathic medicine or placebo. Treatment by homoeopathy showed a significant improvement in the condition in comparison to placebo. Jacobs J., Jimenez M., Malthouse S., Chapman E., Crothers D., Masuk M., Jonas W.B., Acute Childhood Diarrhoea- A Replication., Journal of Alternative and Complementary Medicine, 6, 2000, 131-139. A meta-analysis of childhood diarrhoea trials This meta-analysis of 242 children showed a highly significant result in the duration of childhood diarrhoea (P=0.008). It should be noted that the World Health Organisation consider childhood diarrhoea to be the number one public health problem today because of the millions of children who die every year from dehydration from diarrhoea. J. Jacobs, WB Jonas, M Jimenez-Perez, D Crothers, Homeopathy for Childhood Diarrhea: Combined Results and Meta-analysis from Three Randomized, Controlled Clinical Trials
Respiratory tract complaints
Homeopathy versus conventional treatment in respiratory tract complaints In an outcome study, 30 practitioners in four countries enrolled 500 consecutive patients with at least one of three complaints: upper respiratory tract complaints including allergies; lower respiratory tract complaints including allergies; or ear complaints. Of 456 patients, 281 received homeopathy and 175 conventional treatment. The primary outcome criterion was response to treatment, defined as cured or major improvement after 14 days of treatment. Results showed a response rate of 82.6% in the homeopathy group compared to 67.3% in the group receiving conventional medicine. The authors concluded that homeopathy appeared to be at least as effective as conventional treatment of patients with the three conditions studied. Riley D, Fischer M, Singh B, Haidvogl M, Heger M. Homeopathy and conventional medicine: an outcomes study comparing effectiveness in a primary care setting. J Altern Complement Med 2001; 7: 149–159. Homeopathy versus conventional treatment in recurrent acute rhinopharyngitis in children Prospective pragmatic study, comparison of homeopathy versus antibiotics in the treatment of recurrent acute rhinopharyngitis in children (18 months to 4 years) over a 6 month period. Results showed that homeopathy was significantly better than antibiotics in terms of episodes of rhinopharyngitis (2.71 vs 3.97, p<0.001), number of complications (1.25 vs 1.95, p<0.001) and quality of life (global score: 21.38 vs 30.43, p<0.001). Homeopathic treatment also contributed to lower medical costs (88 Euros vs 99 Euros, p<0.05) and significantly less sick-leave (9.5% of parents vs 31.6% of parents, p<0.001). Trichard M, Chaufferin G, Nicoloyannis N. Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children. Homeopathy. 2005 Jan;94(1):3-9 An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS
Respiratory tract complaints
Homeopathy versus conventional treatment in otitis media Prospective observational study, comparison of homeopathy versus conventional treatment in acute otitis media. Conclusion: homeopathy should be first line treatment in acute otitis media. Results showed median duration of pain of 2 days in the homeopathy-group and 3 days in the conventional medicine group. 70.7 % of the children receiving homeopathic treatment did not have another ear infection the next year and 29.3 % had a maximum of three ear infections within one year. 56.5 % in the conventional medicine group did not have another ear infection the next year and 43.5 % had a maximum of six ear infections the next year. Results showed that in the group receiving homeopathic treatment only 5 out of 103 children needed antibiotics. Friese K-H, Kruse S, Ludtke R, Moeller H "Homeopathic treatment of otitis media in children: comparisons with conventional therapy". Int J Clin Pharmacol Ther. 1997; 35: 296-301. Acute otitis media in children A study involving children suffering from acute otitis media suggests that a positive treatment effect from homeopathy when compared with placebo in acute otitis media cannot be excluded. There were fewer treatment failures in the group receiving homeopathy after 5 days, 2 weeks, and 6 weeks, with differences of 11.4, 18.4, and 19.9%, respectively, but these differences were not statistically significant. Diary scores showed a significant decrease in symptoms at 24 and 64 h after treatment in favour of homeopathy (P<0.05). Jacobs J, Springer DA, Crothers D. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatr Infect Dis J 2001; 20: 177–183.
Acute otitis media in children In a trial of 230 children who were given homeopathic treatment to treat acute otitis media, pain relief was achieved in 39% of the patients after 6 h and another 33% after 12 h. The resolution rates were 2.4 times faster than in placebo controls. No complications were observed and compared to conventional treatment the homeopathic approach was 14% cheaper. Frei H, Thurneysen A. Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? Br Homeopath J 2001; 90: 180–182.
Glue ear in children In a pilot study in children suffering from glue ear treated with homeopathy 75% had normal tympanogram, compared to 31% in the group treated with conventional medicine. A higher proportion of children receiving homeopathic treatment had a hearing loss less than 20 dB at follow-up, though the difference was not statistically significant. The authors concluded that further research comparing homeopathy to standard care is warranted; 270 patients would be needed for a definitive trial. Harrison H, Fixsen A, Vickers A. A randomized comparison of homoeopathic, standard care for the treatment of glue ear in children. Compl Therap Med 1999; 7: 132–135.
Acute sinusitis In an uncontrolled clinical trial of 119 patients suffering from clinical signs of acute sinusitis were treated using homeopathic medicines. Typical sinusitis symptoms, such as headache, pressure pain at nerve exit points, and irritating cough, were reduced after a mean of 4.1 days of treatment. Ninety-nine received only a homeopathic test medication, 20 patients were able to discontinue concomitant medication at the first visit, and only one patient needed antibiotics. Average duration of treatment was 2 weeks. At the end of treatment 81.5 % described themselves as symptom free or significantly improved. No adverse medication effects were reported. Adler M. Efficacy, safety of a fixed-combination homeopathic therapy for sinusitis. Adv Ther 1999; 16: 103–111.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS Musculo-skeletal problems Rheumatoid arthritis Forty-six patients with rheumatoid arthritis received an individualised remedy or placebo in a 3-month randomised trial. Both groups were allowed to continue standard anti-inflammatory drugs. After 3 months, the double-blind code was broken and remedies were given to members of the placebo group in a single crossover study. Articular index, limbering up time, grip strength and pain all showed statistically significant differences. Gibson RG, Gibson SLM, MacNeill AD, Buchanan WW Homeopathic therapy in rheumatoid arthritis: evaluation by double-blind clinical therapeutic trial. British Journal of Clinical Pharmacology 1980; 9: 453-459. Osteoarthritis In this trial, 65 sufferers of Osteoarthritis (OA) were split into 2 groups, and through a double blinding process were given either a homoeopathic medicine or Acetaminophen, a commonly prescribed drug for pain relief in OA. Researchers found that homoeopathy provided a level of pain relief that was superior to Acetaminophen, and produced no adverse reactions. Shealy C.N., Thomlinson P.R., Cox R.H., and Bormeyer V. Osteoarthritis Pain: A Comparison of Homoeopathy and Acetaminophen. American Journal of Pain Management, 8, 3, July 1998, 89-91.
Fibromyalgia A double-blind, randomised, placebo-controlled trial of individualised homeopathic treatment (LM potency) versus placebo in 53 patients, concluded that individualised homeopathy is significantly better than placebo in lessening tender point pain, improving the quality of life and overall health, and less depression of persons with fibromyalgia. A broad selection of homeopathic medicines in LM- potencies were prescribed and the trial was carried out over a 4 month period. Bell IR, Lewis II DA, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin CM. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology Advance Access, January 20, 2004. Fibrositis In a randomised placebo-controlled trial of patients with fibrositis, only those patients in whom Rhus toxicodendron was ‘unequivocally indicated’ were admitted to the study. After 1 month’s treatment, there were highly significant improvements in objective and subjective parameters. Fisher P. An experimental double-blind clinical trial in homoeopathy. British Homoeopathic Journal 1986; 75: 142-147.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS Hay fever, asthma and perennial rhinitis
A study of 200 patients suffering from hypersensitivity illnesses, including asthma, eczema, urticaria, hay fever and other allergies, showed that homeopathy was at least as effective as conventional treatment. The study, which was retrospective and comparative, looked at the experienced effect in everyday clinical practice of general practitioners and classical homeopaths. Where most patients who were treated by medical doctors experienced an aggravation of their symptoms when stopping conventional drugs, only 1/3 of patients in the homeopathy group experienced such an aggravation (P = 0.002). Only one patient on conventional treatment experienced improvement of symptoms after stopping medication, compared to improvement in 2/3 of homeopathy patients. Patients in the homeopathy group reported a larger improvement in their general state of health, with 57% improving, compared to 24% in the conventional group (difference P = 0.004). Homeopathy patients also experienced more positive change in their psychological state (P<0.0001). For quality of life 53% in the homeopathy group improved, compared to 15 % in the conventional group. Launsø L, Kimby CK, Henningsen I, Fønnebø V. An exploratory retrospective study of people suffering from hypersensitivity illness who attend medical or classical homeopathic treatment. Homeopathy (2006) 95, 73-80.
A survey of 147 patients suffering from respiratory allergies showed that 87.6% improved. Out of 42 patients suffering from pulmonary allergies, only two aggravated and three were unchanged. Colin P. Homeopathy and respiratory allergies: a series of 147 cases. Homeopathy (2006) 95, 68–72
Reilly and colleagues have conducted a series of trials in patients with hay fever, asthma and perennial rhinitis. Patients were given skin tests and remedies were chosen on the basis of reactivity. This design allows individualisation whilst avoiding the issues of case-taking and the effect that this has on the process. The results demonstrate a significant difference between the placebo and homeopathic groups which is reproducible. (NB! Strictly speaking these are trials of isopathy.) Anon. Reilly’s challenge (editorial). Lancet 1994; 344: 1585. Reilly DT, Taylor MA. Potent placebo or potency? A proposed study model with initial findings using homoeopathically prepared pollens in hay fever as a model. British Homoeopathic Journal 1985; 74: 65-75. Reilly DT, Taylor MA, Campbell J, Beattie N, McSharry C, Aitchison T, Carter R, Stevenson R. Is evidence for homoeopathy reproducible? Lancet 1994; 334: 1601-1606. Reilly DT, Taylor MA, McSharry C, Aitchison T. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hay fever as a model. Lancet 1986; ii: 881-886. Taylor MA, Reilly D, Llewellyn-Jones RH, McSharry C, Aitchison T, Lancaster T, Vickers A. Randomised controlled trial of homeopathy versus placebo in perennial allergic rhinitis with overview of four trial series British Medical Journal 2000; 321: 471-476. Double-blind clinical trial comparing homeopathic preparations from common allergens (tree, grass, weed) with placebo. 40 patients diagnosed with moderate to severe seasonal allergic rhinitis symptoms were treated over a 4 week period. Results showed significant positive changes in the homeopathy group compared with the placebo group (p<0.05). No adverse effects were reported. Kim LS, Riedlinger JE, Baldwin CM, Hilli L, Khalsa SV, Messer SA, Waters RF. Treatment of Seasonal Allergic Rhinitis Using Homeopathic Preparation of Common Allergens in the Southwest Region of the US: A Randomized, Controlled Clinical Trial. Ann Pharmacother. 2005 Apr;39(4):617- 24. Epub 2005 Mar 1. Related Articles, Links
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS
Pre menstrual syndrome (PMS)
In a randomized controlled double-blind clinical trial (1992-94) 19 women suffering from PMS were treated individually with homeopathy. 90 % of the patients who had received homeopathic treatment experienced more than 30 % improvement. Only 37.5 % of patients who received placebo experienced a similar improvement. Sick-days before menses were reduced from 0.75 to 0 in the homeopathy-group, and was unchanged in the control group. Use of conventional drugs was also reduced in the homeopathy- group. Yakir M, Kreitler S, Brzezinski A, Vithoulkas G, Oberbaum M, Bentwich Z. Effects of homeopathic treatment in women with premenstrual syndrome: a pilot study. Br Homeopath J. 2001 Jul ;90(3): 148- 53.
A randomised controlled trial of homeopathic treatment for PMS confirms that homeopathy is helpful in PMS. Jones A. Homeopathic treatment for premenstrual symptoms. J Fam Plann Reprod Health Care. 2003 Jan;29(1):6-7.
Homeopathy in menopausal complaints
In a prospective study 81.4% of 102 patients reported improvement of menopause symptoms after homeopathic treatment. Main symptoms noted were hot flushes and sweats, tiredness, anxiety, sleeping difficulties, mood swings and headaches. Women referred to homeopathy were those who either could not take hormone replacement treatment (HRT), for whom HRT was unsuccessful, who did not want or who had to come off HRT. Mean length of homeopathic treatment was 5 months. Relton C, Weatherley-Jones E. Homeopathy Service in a National Health Service community menopause clinic: audit of clinical outcomes. Journal of the British Menopause Society, Vol. 11, No. 2, June 2005.
An outcome study and service evaluation of homeopathy service found that 88% of patients reported clinically significant improvement in their primary symptom. Greatest clinical benefit was reported by women for headaches, tiredness, vasomotor symptoms, locomotor symptoms and sleeping difficulties. Thomas KJ, Luff D, Strong P. Complementary Medicine Service in a Community Clinic for Patients with Symptoms Associated with the Menopause: Outcome and Sercive Evaluation. ScHARR, University of Sheffield, 2001.
An observational study of homeopathic treatment of menopausal symptoms found benefit in menopausal symptoms, mood and quality of life. Clover A, Ratsey D. Homeopathic treatment of hot flushes: a pilot study. Homeopathy 2002;91:75-9.
Homeopathy and oestrogen withdrawal
40 out of 45 women with breast cancer withdrawing from oestrogen and then treated homeopathically, experienced significant improvement in their primary symptoms, anxiety and depression, as well as improvement in quality of life. Primary symptoms changed from 7.8 to 5.4, and from 7.2 to 4.1 (p<0.001). The homeopathic approach appears to be clinically useful in the management of oestrogen withdrawal symptoms in women with breast cancer. Thompson EA, Reilly D. The homeopathic approach to the treatment of symptoms of oestrogen withdrawal in breast cancer patients. A prospective observational study. Homeopathy. 2003 Jul;92(3):131-4.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 KEY TRIALS AND SURVEYS
ADHD
A randomised double blind placebo controlled crossover trial of 62 children showed significant improvement of visual global perception, impulsivity and divided attention (p<0.0001). The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of ADHD, particularly in the areas of behavioural and cognitive functions. Frei H, Everts R, von Ammon K, Kaufman F, Walther D, Hsu-Schmitz SF, Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen An. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. Eur J Pediatr. 2005 Jul 27.
In a trial to assess the efficacy of homeopathy in 115 hyperactive patients (mean age 8.3 years, range 3-17 y) compared to methylphenidate 75% of the children responded to homeopathy, reaching a clinical improvement rating of 73%. Children who did not respond to homeopathic treatment were prescribed methylphenidate (after an average period of 22 months of homeopathic treatment). Frei H, Thurneysen A. Treatment for hyperactive children: homeopathy and methylphenidate compared in a family setting. Br Homeopath J. 2001 Oct;90/4):178-9.
ME/CFS
A randomised double-blind trial involving 62 patients with ME, reported in some detail, found that 33% of patients in the group receiving homeopathic remedies showed definite improvement compared with none in the placebo group. Awdry R. Journal of Alternative and Complementary Medicine 1996; February, March, April.
In a triple-blind randomised controlled trial of 86 patients suffering from chronic fatigue syndrome (CFS) patients in the homeopathic medicine group showed clinically significant improvement with significantly more improvement on fatigue, compared to patients receiving placebo. Weatherley-Jones E, Nicholl JP, Thomas KJ, Parry GJ, McKendrik MW, Green ST, Stanley PJ, Lynch SPJ. A randomised, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatique syndrome. Journal of Psychosomatic Research 56 (2004) 189-197.
Surgery
In a survey of 26 patients receiving homeopathic Arnica montana or placebo after face-lift operation, patients receiving homeopathic Arnica montana had statistically significant smaller areas of ecchymosis (bruising) after operation. Seeley BM, Denton AB, Ahn MS, Maas CS. Effect of Homeopathic Arnica montana on Bruising in Face-lifts. Results of a Randomized, Double-blind, Placebo-Controlled Clinical Trial. Arch Facial Plast Surg/Vol 8, Jan/Feb 2006. Dengue haemorrhagic fever
Dengue haemorrhagic fever Dengueinum 30 was administered to at least 39,200 people in the Delhi area during an epidemic of Dengue haemorrhagic fever. Follow-up of 23,520 people 10 days later showed only 5 people (0.125%) had developed mild symptoms, with the rest showing no signs or symptoms of the disease. (During epidemics of dengue, attack rates among susceptible are often 40-50 %, but may reach 80-90 %, World Health Organisation) Central Council of Research in Homoeopathy. CCRH News 1996-1997.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 Cost benefit
In a comparative cohort study of 493 patients with chronic diagnoses results indicated greater improvement in patients’ assessments after homeopathic versus conventional treatment (adults: homeopathy from 5.7 to 3.2; conventional 5.9 to 4.4, p = 0.002; children: from 5.1 to 2.6, and 3.9 to 2.7, p < 0.001). Physician assessments were also more favourable for children who had received homeopathic treatment. There were no significant differences in costs between the two treatment groups. Witt C, Keil T, Selim D, Roll S, Vance W, Wegscheider K, Willich SN. Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. Complementary Therapies in Medicine (2005) 13, 79-86.
A 4-year study of 84 patients treated homeopathically showed average cost savings for drugs per patient of £60.40 (range £12.48 to £703.95). 64 patients were cured, 16 showed significant improvement, 5 moderate improvement affecting daily living, 5 showed no change or were unsure, and 10 are still under treatment. No side-effects of treatment were reported. Jain A. Does homeopathy reduce the cost of conventional drug prescribing? A study of comparative prescribing costs in General Practice. Homeopathy (2003) 92, 71-76.
In a survey of 223 patients in an NHS General Practice, the number of consultations with general practitioners was reduced by 70% in a 1 year period. Expenses for medication were reduced by 50% when homeopathic treatment was made available. Christie EA, Ward AT. Report on NHS practice-based homoeopathy project. Analysis of effectiveness and cost of homoeopathic treatment within ad GP practice at St. Margaret’s Surgery, Bradford on Avon, Wilts. September 1996. The Society of Homeopaths. ISBH 1 901262 006.
In a study of 351 adults suffering from allergies, 35.3% received homeopathic treatment, the researchers concluded that alternative medicine is used widely for allergies by the general population and is associated with considerable costs. This has freedom of choice and cost-benefit implications for the healthcare system and health policy. The study also showed that alternative medicine users were better educated than non-users, and assessed the results of alternative medicine as very good (28.6%) or rather good (53.8%). Schafer T, Riehle A, Wichmann HE, RingJ. Alternative medicine in allergies—prevalence, patterns of use, and costs. Allergy 2002; 57: 694–700.
A study of the cost and effectiveness of homeopathy suggested that doctors practising homeopathy issue fewer prescriptions and at a lower cost than their colleagues. The main costs for homeopathic treatment are for consultations with each individual patient. Costs for the actual medications used are relatively low, particularly when compared with conventional drugs. Swayne J. The cost, effectiveness of homoeopathy. A pilot study, proposals for future research. Br Homoeopath J 1992; 81: 148–150.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 Basic research
The effect of high dilutions
In an experimental study of ultra-high dilutions of litihum chloride and sodium chloride, researchers found emission of light even in dilutions beyond Avogadro’s number (10-30 g cm-3). The solutions were irradiated by x- and gamma-rays at 77 K, then progressively rewarmed to room temperature. Thermoluminescence was studied during the process. Rey L. Thermoluminescence ofultra-high dilutions of lithium chloride and sodium chloride. Physica A 323 (2003) 67–74.
In an experimental study of extremely diluted and succussed solutions (< 1x10-5 mol kg-1, chemically identical to distilled water) researchers found that the diluted and succussed solution resulted in exothermic excess of heat (heat resulting from chemical reactions), higher electrical conductivity and pH compared to an untreated substance. The authors conclude that they show that successive dilutions and succussions can permanently alter the physico-chemical properties of the water solvent. The authors are unable to explain the phenomena. Elia V, Niccoli M. New physico-chemical properties of extremely diluted aqueous solutions. Journal of Thermal Analysis and Calorimetry, Vol. 75 (2004) 815–836. In a multi-centre study including four research centres in Europe the effect of high dilutions of histamine (10-30 – 10-38 M) were confirmed. Researchers were able to document that high dilutions of histamine inhibit human basophil degranulation. Results cannot be explained through molecular theories. Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Sainte-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activation. Inflamm. Res. 2004; 53: 181-188.
The effect of high dilutions was documented in an experiment showing the effect of highly diluted Belladonna on acetylcholine-induced contraction of the rat ileum. The model is reproducible and highly recognised in ‘the scientific world’. Bastide M (ed). Signals and Images. Kluwer Academic Publishers 1997: 161-170
A placebo-controlled homeopathic pathogenic trial, more commonly known as a proving, clearly demonstrated that provers who took the substances in C30 potency experienced significantly more symptoms than a placebo group (P<0.001). Provers were given either Etna Lava C30, Hydrogenium peroxidatum C30, or placebo. Where the placebo group experienced some symptoms, they were more short-lived compared to the verum group which experienced persistent symptoms for the first 30 days. Provers in the verum group also experienced more ‘old symptoms’ returning. A weakness of the survey is that it only included 21 provers. Researchers have now called for more data from more provers. Dominici G, Bellavite P, di Stanislao C, Gulia P, Pitari G. Double-blind, placebo-controlled homeopathic pathogenetic trials: Symptom collection and analysis. Homeopathy (2006) 96, 123-130.
In an experimental study on the effect of histamine on basophile granulocytes, researchers found an effect of histamine diluted beyond Avogadro’s number. Lorenz I, Schneider EM, Stolz P, Brack A, Strube J. Sensitive flow cytometric method to test basophil activation influenced by homeopathic histamine dilutions. 2003 Dec;10(6):316-24.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 Treatment of animals
In a blinded study where rats were treated for urinary infections results showed that rats treated with homeopathic remedies had clear reduction of bacterial colonies. Results were at least as clear as for treatment with antibiotics. Untreated rats had no changes in bacteria colonies, compared to a reduction to 33 % of original bacteria levels in rats treated with antibiotics, and 22 % and 39 % in rats treated with homeopathic remedies (Phosphorus and self-nosode). Gonçalves et al. O uso da homeopatia no tratamento da infecção urinária em ratas. Anais do VIII SINAPIH; 20-22 May, 2004: p.25-26.
A study of homeopathically protentised remedies showed a reduction in the need for repetition of insemination and reduced semen loss in treatment of fertilisation of female pigs. Riaucourt A. L´Exemple de la Filière Porcine. Annals of the “Entretiens Internationaux de Monaco 2002”, 5-6 October, 2002.
In a study of homeopathically potentised remedies the incidence of haematomas was reduced by 30 % in turkeys during transportation. The study was randomised, placebo controlled and double blinded. Filliat C. Particularité de l´utilisation de l´homéopathie en production avicole. Annals of the “Entretiens Internationaux de Monaco 2002”, 5-6 October 2002.
An Overview of Positive Homeopathy Research and Surveys, ENHR, November 2006 RESEARCH WEBSITE ADDRESSES
CAM base HomBRex Databse (Carsten Pubmed (National Library of Medici British Medical Journal for 'homeopathy') New Scientist for 'homeopathy') Healthworld Online (Medline, Medical Research & Document Delivery)
Biomail This site offers free regular updates by e-mail. Hosted by Medical Informatics Department at State University of New York, Stony Brook University Hospital and Medical Centre. An evidence-based resource about Complementary and Alternative Medicine Funded by the New Zealand Ministry of Health. Annals of Internal Medicine University of York Biomed Central (homeopathy revie British Homeopathic Libr The Research Council for Complementary Medici Groupe International de Recherche sur l'Infinitésimal National Centre for Complementary and Alternative Medicine (search for 'homeopathy') National Centre for Homeopathy Homeopathic Educational Services Homeopathy (the journal) Boiron Official Indian research centre Carstens stiftung (Germany) ish pages) ISI Web of Knowledge (resembles PubMed but includes more areas)
BMC Complementary and Alternative Medicine (free articles)
NAFKAM, Tromsø (Norway) (research info will be included) Vifab (Denmark) Townsend Letter for Doctors & Patients publishes a print alternative medicine magazine.
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