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Wilhelm M, Hermann C, Rief W, Schedlowski M, Bingel U, Winkler A. Working with patients' treatment expectations - what we can learn from homeopathy. Front Psychol 2024; 15:1398865. [PMID: 38860049 PMCID: PMC11163137 DOI: 10.3389/fpsyg.2024.1398865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
The usual homeopathic remedy, "globules," does not contain any pharmacologically active ingredient. However, many patients and practitioners report beneficial effects of homeopathic treatment on various health outcomes. Experimental and clinical research of the last two decades analyzing the underlying mechanisms of the placebo effect could explain this phenomenon, with patients' treatment expectations as the predominant mechanism. Treatment expectations can be optimized through various factors, such as prior information, communication, and treatment context. This narrative review analyses how homeopathy successfully utilizes these factors. Subsequently, it is discussed what evidence-based medicine could learn from homeopathic practice to optimize treatment expectations (e.g., using an empathic, patient-centered communication style, deliberately selecting objects in practice rooms, or using clear treatment rituals and salient contextual stimuli) and thereby treatment effectiveness. Homeopathic remedy does not work beyond the placebo effect but is recommended or prescribed as an active treatment by those who believe in it. Thus, practitioners need to understand the manner in which homeopathy (as an example of inert treatment) works and are advised to reintegrate its underlying effective placebo mechanisms into evidence-based medicine. This promises to increase treatment efficacy, tolerability, satisfaction, and compliance with evidence-based treatments, and addresses the desires patients are trying to satisfy in homeopathy in an ethical, fully informed way that is grounded in evidence-based medicine.
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Affiliation(s)
- Marcel Wilhelm
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Christiane Hermann
- Department of Clinical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Winfried Rief
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Essen, Essen, Germany
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulrike Bingel
- Department of Neurology, Center for Translational Neuro-and Behavioral Sciences, University Medicine Essen, Essen, Germany
- Translational Pain Research Unit, University Medicine Essen, Essen, Germany
| | - Alexander Winkler
- Department of Clinical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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2
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Teixeira da Silva JA, Bornemann-Cimenti H, Daly T, Türp JC. Beyond disclaimers: the need for a curation-based model of PubMed. Curr Med Res Opin 2024:1-7. [PMID: 38700245 DOI: 10.1080/03007995.2024.2350612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024]
Abstract
According to its own description, the biomedical meta-database PubMed exists "with the aim of improving health-both globally and personally." Unfortunately, PubMed contains an increasing amount of low-quality research that may detract from this goal. Currently, PubMed warns its users and protects itself from such problems with a disclaimer stating that the presence of any article, book, or document in PubMed does not imply an endorsement of, or concurrence with, its contents by the NLM, the National Institutes of Health (NIH), or the U.S. Federal Government. However, we are critical of a "disclaimer-only" stance and encourage PubMed to take further action against low-quality research being found and indexed in its database, and thus available for use. To address this problem, we offer two lines of reasoning to argue that PubMed should not function merely as a passive index of health-related research. Instead, we first argue that only trustworthy published research is able to further PubMed's goal of health improvement. Secondly, on the basis of surveys, we argue that researchers place a high level of trust in articles that are referenced in this meta-database. We cannot expect any one set of actors to ensure trustworthy content on PubMed, which requires collective responsibility among authors, peer reviewers, editors, and indexers alike. Instead, we propose a curation-based model that incorporates three mechanisms of collaborative content curation: open expert feedback on indexed content, journal auditing, and constant transparent reassessment of indexed entities.
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Affiliation(s)
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Timothy Daly
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France
| | - Jens C Türp
- Department of Oral Health & Medicine, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
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Leemhuis H, Seifert R. Prescriptions of homeopathic remedies at the expense of the German statutory health insurance from 1985 to 2021: scientific, legal and pharmacoeconomic analysis. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03005-x. [PMID: 38430230 DOI: 10.1007/s00210-024-03005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
The prescription of homeopathic remedies at the expense of the statutory health insurance (SHI) system in Germany has been criticized for years due to a lack of evidence. Now, on the planned abolition of the reimbursement of homeopathic medicines in Germany, the debate on this topic has been reignited. The aim of this paper is to show the costs and their development over time incurred by homeopathic remedies in the healthcare system from 1985 to 2021. For this purpose, 15 selected homeopathic medicines were chosen from the drug prescription report (Arzneiverordnungsreport) and analyzed with regard to their development of DDD (Defined Daily Dose) using data from the Wissenschaftliches Institut der Ortskrankenkassen (WidO, Scientific Institute of the General Local Health Insurance Funds) and compared with their respective rational pharmacological alternatives. The price comparison was based on the DDD costs and the pharmacy retail price of the smallest packaging in each case. The clinical study situation for the preparations was also analyzed. For this purpose, the clinical studies provided by the manufacturer and those on PubMed were divided into evidence levels and analyzed. In addition, the presentation of homeopathic remedies on company websites, in online pharmacies, in specialist information and package leaflets was analyzed with regard to side effects, interactions, indication, and information on the alleged effect/proof of efficacy. In many media, information on homeopathic medicines remained incomplete, and non-compliance with the Therapeutic Product Advertising Act (Heilmittelwerbegesetz) was noted. Naming of the products if often very suggestive, too. Manufacturers' claims of efficacy go far beyond what can be considered proven in terms of evidence-based medicine and the quality of most clinical studies is poor. Homeopathic remedies are on average significantly more expensive than their rational pharmacological alternatives. Furthermore, DDD costs have continued to rise over the years analyzed. In aggregate, from a pharmacoeconomic, legal, and scientific perspective, abolition of reimbursement of homeopathic medicines in Germany at the expense of the SHI system is well justified.
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Affiliation(s)
- Hauke Leemhuis
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625, Hannover, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625, Hannover, Germany.
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Sinha S, Kar C, Das S, Dutta A, De A. A Clinico-Epidemiological Study of Cutaneous Adverse Drug Reactions in a Tertiary Care Centre of Eastern India. Indian J Dermatol 2024; 69:106. [PMID: 38572036 PMCID: PMC10986873 DOI: 10.4103/ijd.ijd_944_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Background Adverse drug reactions (ADRs) are major problems in the drug therapy. Cutaneous adverse drug reactions (CADRs) are the most common ADRs. The pattern of CADRs differs among various drugs. Aims To record various morphological patterns of CADRs and their causal relationships among patients attending in a tertiary care centre. Materials and Methods An observational, cross-sectional, clinical study was conducted for a duration of one and a half years in a tertiary care centre in eastern India. Patients presenting with suspected CADRs were included if drug identity could be ascertained. Clinical profiling and drug history were recorded, and causality assessment was carried out as per the Naranjo scale. Result The commonest CADR in our study was fixed drug eruption (FDE) 48.61%, followed by SJS-TEN spectrum 16.66%, maculopapular rash 11.11% and so on. Severe cutaneous adverse drug reactions (SCARs) such as SJS, TEN, SJS-TEN Overlap, AGEP and DRESS accounted for 18 cases (25%). The most common culprit drugs were antimicrobials (54.16%), followed by nonsteroidal anti-inflammatory drugs (15.27%) and anticonvulsants (12.5%). Most of the CADRs were in probable category. Conclusion The pattern of CADRs and the drugs causing them in our study population are similar to some previous studies but somewhat different from most of the previous Indian studies. The incidence of SCARs was significantly higher than in previous other studies in India and abroad.
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Affiliation(s)
- Sujata Sinha
- From the Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Chinamy Kar
- From the Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Sudip Das
- From the Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Arnab Dutta
- From the Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Abhishek De
- From the Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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Cortiñas-Rovira S, Salvador-Mata B. The suggestive nature of words. Media coverage of homeopathy, acupuncture, reiki and Bach flower remedies in Spanish press 2011-2016. J Biosoc Sci 2023; 55:1178-1192. [PMID: 36278509 DOI: 10.1017/s0021932022000384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The maxim of proponents of pseudoscience is to spread ignorance through false perceptions of its scientific status. One of its most attractive - and simultaneously harmful - manifestations is complementary and alternative medicine (CAM). Despite the scientific evidence against them, CAM has taken hold in today's society as a therapeutic model for a growing segment of the population. We analysed 379 articles on homeopathy, acupuncture, reiki and Bach flower remedies published in mainstream Spanish newspapers (El País, El Mundo, La Vanguardia, El Periódico and ABC) for the period 2011-2016, finding that disinformation is participated in actively by the Spanish press. CAM content was detected in these newspapers, together with a lack of an editorial perspective. In most of the cases, the uncritical articles were found in the interpretive genre and the society section. We also characterized the pseudoscientific discourse aimed at the public, finding that it is irrational and fraudulent in sowing fear and distrust regarding science. On the basis of theories invalidated by the scientific method and on appeals to the emotions, pseudoscience not only threatens scientific knowledge, but directly undermines public health by encouraging the abandonment of conventional medicine. In order to remedy this situation, better scientific training, informative screening and editorial commitment is urgently needed in the Spanish press.
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Affiliation(s)
- Sergi Cortiñas-Rovira
- Research Group in Science Communication (GRECC), Department of Communication, Universitat Pompeu Fabra (UPF), Roc Boronat 138, Barcelona08018, Spain
- UPF Barcelona School of Management, Bareclona, Spain
| | - Bertran Salvador-Mata
- Research Group in Science Communication (GRECC), Department of Communication, Universitat Pompeu Fabra (UPF), Roc Boronat 138, Barcelona08018, Spain
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Keyßer G, Michalsen A, Reuß-Borst M, Frohne I, Gläß M, Pfeil A, Schultz O, Seifert O, Sander O. [Recommendations of the committee on complementary medicine and nutrition in ayurvedic medicine, homeopathy, nutrition and Mediterranean diet]. Z Rheumatol 2023:10.1007/s00393-023-01356-z. [PMID: 37212842 PMCID: PMC10382356 DOI: 10.1007/s00393-023-01356-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 05/23/2023]
Abstract
Methods of complementary and alternative medicine (CAM) are appealing for many patients with rheumatic diseases. The scientific data are currently characterized by a large number of publications that stand in contrast to a remarkable shortage of valid clinical studies. The applications of CAM procedures are situated in an area of conflict between efforts for an evidence-based medicine and high-quality therapeutic concepts on the one hand and ill-founded or even dubious offers on the other hand. In 2021 the German Society of Rheumatology (DGRh) launched a committee for CAM and nutrition, which aims to collect and to evaluate the current evidence for CAM applications and nutritional medical interventions in rheumatology, in order to elaborate recommendations for the clinical practice. The current article presents recommendations for nutritional interventions in the rheumatological routine for four areas: nutrition, Mediterranean diet, ayurvedic medicine and homeopathy.
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Affiliation(s)
- Gernot Keyßer
- Klinik für Innere Medizin II, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Deutschland.
| | - Andreas Michalsen
- Immanuel Krankenhaus Berlin, Königstr. 63, 14109, Berlin-Wannsee, Deutschland
| | - Monika Reuß-Borst
- Facharztpraxis für Innere Medizin, Frankenstr. 36, 97708, Bad Bocklet, Deutschland
| | - Inna Frohne
- Privatpraxis für Rheumatologie, Frankenstr. 238, 45134, Essen, Deutschland
| | - Mandy Gläß
- Helios Fachklinik Vogelsang-Gommern, Sophie-von-Boetticher-Str. 1, 39245, Vogelsang-Gommern, Deutschland
| | - Alexander Pfeil
- Klinik für Innere Medizin III, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - Olaf Schultz
- Rheumazentrum, ACURA Kliniken Baden-Baden, Rotenbachtalstr. 5, 76530, Baden-Baden, Deutschland
| | - Olga Seifert
- Klinik und Poliklinik für Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, Haus 4, 04103, Leipzig, Deutschland
| | - Oliver Sander
- Klinik für Rheumatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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Theruvath AH, Raveendran R, Philips CA, Ahamed R, Abduljaleel JK, Tharakan A, Rajesh S, Augustine P. A series of homeopathic remedies-related severe drug-induced liver injury from South India. Hepatol Commun 2023; 7:e0064. [PMID: 36757412 PMCID: PMC9916127 DOI: 10.1097/hc9.0000000000000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/10/2022] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Homeopathic remedies are highly diluted formulations without proven clinical benefits, traditionally believed not to cause adverse events. Nonetheless, published literature reveals severe local and non-liver-related systemic side effects. We present the first series on homeopathy-related severe drug-induced liver injury (DILI) from a single center. METHODS A retrospective review of records from January 2019 to February 2022 identified 9 patients with liver injury attributed to homeopathic formulations. Competing causes were comprehensively excluded. Chemical analysis was performed on retrieved formulations using triple quadrupole gas chromatography-mass spectrometry and inductively coupled plasma atomic emission spectroscopy. RESULTS Males predominated with a median age of 54 years. The most typical clinical presentation was acute hepatitis, followed by acute on chronic liver failure. All patients developed jaundice, and ascites were notable in one-third of the patients. Five patients had underlying chronic liver disease. COVID-19 prevention was the most common indication for homeopathic use. Probable DILI was seen in 77.8%, and hepatocellular injury predominated (66.7%). Four (44.4%) patients died (3 with chronic liver disease) at a median follow-up of 194 days. Liver histopathology showed necrosis, portal and lobular neutrophilic inflammation, and eosinophilic infiltration with cholestasis. A total of 29 remedies were consumed between 9 patients, and 15 formulations were analyzed. Toxicology revealed industrial solvents, corticosteroids, antibiotics, sedatives, synthetic opioids, heavy metals, and toxic phyto-compounds, even in 'supposed' ultra-dilute formulations. CONCLUSION Homeopathic remedies potentially result in severe liver injury, leading to death in those with underlying liver disease. The use of mother tinctures, insufficient dilution, poor manufacturing practices, adulteration and contamination, and the presence of direct hepatotoxic herbals were the reasons for toxicity. Physicians, the public, and patients must realize that Homeopathic drugs are not 'gentle placebos.'
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Affiliation(s)
- Arif Hussain Theruvath
- Division of Complementary and Alternative Medicine (Homoeopathy), Department of Clinical Research, The Liver Institute, Center for Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala, India
| | - Resmi Raveendran
- Division of Complementary and Alternative Medicine (Ayurveda), Department of Clinical Research, The Liver Institute, Center for Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala, India
| | - Cyriac Abby Philips
- Clinical and Translational Hepatology & Monarch Liver Laboratory, The Liver Institute, Center for Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala, India
| | - Rizwan Ahamed
- Gastroenterology and Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Kerala, India
| | - Jinsha K Abduljaleel
- Gastroenterology and Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Kerala, India
| | - Ajit Tharakan
- Gastroenterology and Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Kerala, India
| | - Sasidharan Rajesh
- Interventional Hepatobiliary Radiology, The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Kerala, India
| | - Philip Augustine
- Gastroenterology and Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Kerala, India
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Zadey S. Yes to pluralistic health system, but no to homeopathy. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 10:100172. [PMID: 37383360 PMCID: PMC10305988 DOI: 10.1016/j.lansea.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/10/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Siddhesh Zadey
- Corresponding author. 215, Bajaj Nagar, Nagpur, Maharashtra 440010, India.
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Niszczota P, Petrova D. Treatment choice in the presence of conflicting information: The role of physician likeability in the choice of non-proven therapies against conventional treatment. Br J Health Psychol 2021; 27:501-515. [PMID: 34542194 DOI: 10.1111/bjhp.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/02/2021] [Indexed: 11/27/2022]
Abstract
Research on why patients sometimes choose non-proven therapies (NPT) instead of conventional treatments is limited. We investigated how physician likeability influences the choice of NPT instead of conventional treatment. In an experiment with three medical scenarios, participants (N = 384) consulted two physicians who gave conflicting recommendations: The first physician recommended a conventional treatment and the second one recommended a NPT. We manipulated the likeability of the first physician, who was either likeable or unlikeable. Using mediation analyses, we explored how the effect of likeability was channelled and whether time pressure influenced treatment choice. Participants chose the NPT more often (OR = 1.43, 95% CI [1.03-2.00]), had more positive affective responses, and perceived more benefit from NPT when the conventional treatment was recommended by an unlikeable (vs. likeable) physician. Time pressure had no effect on treatment choice. Physicians' likeability might play an important role in treatment choice in the presence of conflicting information. Providers should be cognizant that poor communication might push patients to prefer the advice of more likeable physicians, even when they prescribe NPT instead of conventional treatment.
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Affiliation(s)
| | - Dafina Petrova
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Andalusian School of Public Health (Escuela Andaluza de Salud Pública), Granada, Spain.,Biomedical Research Institute ibs.GRANADA (Instituto de Investigación Biosanitaria ibs.GRANADA), Spain.,University of Granada, Spain
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10
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[Complementary medicine in uro-oncology]. Urologe A 2021; 60:953-962. [PMID: 34129061 DOI: 10.1007/s00120-021-01584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
Complementary and alternative medicine (CAM) is widespread in oncology patients with a user rate of approximately 40-50%. An accompanying supportive effect can arise through improved adherence, especially in long-term (e.g. endocrine) therapies through active patient involvement. When assessing the evidence on frequently requested methods, there is no high-quality evidence that homeopathy or anthroposophy leads to an improved prognosis. Mistletoe therapy can be considered to improve the quality of life, although the data quality is weak. In prostate cancer, pomegranate has an influence on the prostate-specific antigen. It is currently unclear whether this will also result in an improved prognosis. In contrast the evidence on selenium and vitamin D speaks in favor of integration into the aftercare concept. Supplementation is recommended after the serum level has been determined.
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Morrissey AM, O’Neill A, O’Sullivan K, Robinson K. Complementary and alternative medicine use among older adults with musculoskeletal pain: findings from the European Social Survey (2014) special module on the social determinants of health. Br J Pain 2021; 16:109-118. [PMID: 35111319 PMCID: PMC8801684 DOI: 10.1177/20494637211023293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined. Methods: Cross-sectional European Social Survey Round 7 data from 21 countries were examined for participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months. Results: Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one CAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homoeopathy and 5.3% reporting herbal treatments. A general trend of higher CAM use in younger participants was noted. CAM use was associated with physiotherapy use, female gender, higher levels of education, being in employment and living in West Europe. Those reporting multiple health problems were more likely to use all CAM treatments, except MBBT. Conclusion: A third of older Europeans with musculoskeletal pain report CAM use in the previous 12 months. Certain subgroups with higher rates of CAM use could be identified. Clinicians should comprehensively and routinely assess CAM use among older adults with musculoskeletal pain.
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Affiliation(s)
- Ann-Marie Morrissey
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Aoife O’Neill
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Kieran O’Sullivan
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
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12
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Yildiz Y, Yavuz AY. Complementary and alternative medicine use in children with asthma. Complement Ther Clin Pract 2021; 43:101353. [PMID: 33756219 DOI: 10.1016/j.ctcp.2021.101353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Complementary and Alternative Medicine (CAM) is increasingly used in the treatment of asthma in children. In the studies conducted, it was stated that there was a standardization problem in CAM methods. Moreover, this situation raises the question of "Which is the most widely used CAM method?" in asthma treatment. This study aimed to determine the use of CAM methods in children who are followed up with the diagnosis of asthma. MATERIAL AND METHODS The patients aged 4-10 years who were diagnosed with asthma by a physician in the past and who admitted to the Child Health and Diseases Polyclinic of a hospital issuing tertiary health service in Turkey were included in the study. The demographic data of patients and CAM methods used were examined. RESULTS The median age of a total of 164 asthmatic children included in the study was 6.3 (4-10) years, and 58.3% of them were observed to be male. The median time to diagnosis of the patients was 2.0 (1; 105) months, mostly having multiple cough attacks per day (33.1%), and the rate of children with cough attacks at least once a month to awaken from sleep at night was 47.6%. Honey (36.6%) was found to be one of the most preferred biological-based therapies for families and was followed by molasses (16.9%), which were derived from herbal and natural products. CONCLUSIONS There are varying rates of CAM use in asthmatic children all over the world, and it was found that honey was used the most in our study. Atopy can be found in the etiology of asthmatic patients. Therefore, it should not be forgotten that using different CAM methods at the same time may pose a risk.
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Affiliation(s)
- Yasin Yildiz
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Pediatrics, Rize, Turkey.
| | - Ayten Yilmaz Yavuz
- Recep Tayyip Erdogan University, School of Health, Department of Public Health Nursing, Rize, Turkey
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13
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Suratos CT, Del Rosario MM, Jamora RD. Serotonin syndrome in a Parkinson disease patient after intake of an ethanol-containing homeopathic medication. Neurodegener Dis Manag 2020; 10:219-222. [PMID: 32664782 DOI: 10.2217/nmt-2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Serotonin syndrome is due to excess serotonin in the nervous system. We document a case of an elderly Parkinson disease patient who has been neurologically stable on rasagiline and escitalopram for 1 year but developed serotonin syndrome after intake of an ethanol-containing homeopathic medication. The patient presented with seizures, autonomic dysfunction and neuromuscular hyperexcitability. Maintenance medications were discontinued, hydration, sedation and respiratory support were provided with resolution of the symptoms. The combination of escitalopram and ethanol, both metabolized by the cytochrome P450 enzyme system can lead to serotonin syndrome. Our case highlights the importance of drug interactions in patients taking several medications. Additionally, the intake of medicines, may it be conventional or homeopathic medicine, without the guidance of a trained and competent physician, may lead to serious consequences for the patient.
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Affiliation(s)
- Cezar Thomas Suratos
- Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Mark M Del Rosario
- Section of Neurology, Institute for Neurosciences, St Luke's Medical Center, Quezon City, Philippines
| | - Roland Dominic Jamora
- Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Movement Disorders Service, Institute for Neurosciences, St Luke's Medical Center, Quezon City & Global City, Philippines
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Marraccini P, Lari SA, Conforti E, Pignatti P. Antibiotic drug not always the culprit: Allergy to a homoeopathic product. Int J Clin Pract 2020; 74:e13500. [PMID: 32168405 DOI: 10.1111/ijcp.13500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Paolo Marraccini
- U.O.C. Medicina del Lavoro, Clinica del lavoro, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simone Aldo Lari
- Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Milano, Milan, Italy
| | - Emanuele Conforti
- Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Pignatti
- U.O.C. di Medicina del Lavoro, Sezione di Allergologia, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
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Salvador-Mata B, Cortiñas-Rovira S. Pharmacists' Attitudes to and Perceptions of Pseudoscience: How Pseudoscience Operates in Health and Social Communication. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:321-333. [PMID: 32628068 DOI: 10.1080/19371918.2020.1785983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Given the expansion of pseudoscience, there is a need to understand its mechanisms of diffusion. Our aim was to evaluate how pseudoscience operates among pharmacists. We performed 29 semi-structured interviews to assess the stance of pharmacists regarding pseudoscience. Interview data were analyzed qualitatively to seek common themes. Our results indicate that although pharmacists were broadly opposed to more extreme pseudoscientific practices, some attitudes were detected that may contribute to pseudoscience acceptance. We identified some of the processes by means of which pseudoscience boundaries with science are blurred: the minimization of risk, the hierarchy of health-related pseudoscientific therapies, inappropriate utilization of the notion of "innocuousness," and the use of the placebo effect as a justification for prescription. Discursive patterns typical of pseudoscientific argumentation were also recognized, such as contradictory arguments and the sequndum quid and ad antiquitatem fallacies, which, we conclude, may contribute to a greater acceptance of pseudoscience.
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Affiliation(s)
- Bertran Salvador-Mata
- Research Group in Science Communication (GRECC), Department of Communication, Universitat Pompeu Fabra (UPF) , Barcelona, Spain
| | - Sergi Cortiñas-Rovira
- Research Group in Science Communication (GRECC), Department of Communication, Universitat Pompeu Fabra (UPF) , Barcelona, Spain
- UPF Barcelona School of Management , Bareclona, Spain
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Taype-Rondan A, Miñan-Tapia A, Alarcon-Ruiz CA, Zafra-Tanaka JH. Factores asociados a la percepción de la validez científica de la homeopatía en un grupo de médicos generales de Perú. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n2.72116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La homeopatía es una terapia ampliamente utilizada en diversas partes del mundo; sin embargo, su eficacia no se ha comprobado científicamente.Objetivo. Evaluar los factores asociados a la percepción de la validez científica de la homeopatía en médicos generales de Perú.Materiales y métodos. Estudio transversal analítico. Se realizaron encuestas autoaplicadas a médicos generales que asistieron a los cursos de capacitación y orientación vocacional en especialidad y residentado en salud del Colegio Médico del Perú en 2017. La variable principal del estudio se evaluó por medio de la siguiente pregunta: ¿considera que la eficacia de la homeopatía está científicamente probada? Para evaluar los factores asociados se calcularon razones de prevalencia crudas (RP) y ajustadas (RPa), así como sus intervalos de confianza al 95% (IC95%).Resultados. Se incluyeron 285 médicos generales (55.1% mujeres) con una edad mediana de 28 años. Del 67.4% que reportó haber escuchado sobre la homeopatía, 22.5% consideró que su eficacia estaba científicamente comprobada. Lo anterior fue más frecuente en mujeres (RPa: 1.80; IC95%: 1.03-3.16) y menos frecuente en quienes habían publicado algún artículo científico (RPa: 0.23; IC95%:0.06-0.88).Conclusiones. Una parte de los médicos encuestados considera que la eficacia de la homeopatía está científicamente comprobada. Lo anterior puede deberse a vacíos en la educación médica con respecto a las terapias médicas alternativas y complementarias, así como a la influencia de la educación no formal en la toma de decisiones del médico joven.
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Stub T, Kristoffersen AE, Overvåg G, Jong MC. An integrative review on the information and communication needs of parents of children with cancer regarding the use of complementary and alternative medicine. BMC Complement Med Ther 2020; 20:90. [PMID: 32183808 PMCID: PMC7079450 DOI: 10.1186/s12906-020-02882-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Parents often choose Complementary and Alternative Medicine (CAM) as a supportive agent with the aim to reduce cancer treatment-related symptoms in their children. Therefore, it is necessary to understand parents´ information and communication needs regarding CAM. The aim of the present study was to review the research literature as to identify the information and communication needs of parents of children with cancer, and the children themselves, regarding the use of CAM. Methods An integrative systematic review design was chosen. Searches were performed in AMED, CAMbase, CINAHL (Ebsco), EMBASE, PubMed and PsycInfo, Theme eJournals and Karger. The search was limited to studies published in English, German, Dutch, and the Scandinavian languages. Using predefined inclusion and exclusion criteria, two reviewers independently screened the title and abstracts of the relevant papers. A data extraction form and critical appraisal checklists were used to extract data for analysis, and a mixed methods synthesis was applied. Results Out of 24 studies included, 67% were of quantitative and 33% of qualitative study design. Five main themes emerged from the analysis of 21 studies: Information on CAM, sources of CAM information, communication about CAM, informed decision-making on CAM, and Risk/benefit of CAM. The majority of the parents did not disclose the CAM use of their children because they feared negative reactions from the attending oncologist. To make informed treatment decisions for their children, parents wanted unbiased information about CAM and would act accordingly. They demand open communication about these modalities and respect for the family’s autonomy when choosing CAM for their children. Conclusion There is an urgent need for parents of children with cancer for high quality information on CAM from reliable and scientific sources. Development of authoritative evidence-based decision tools is thus warranted to enable health care professionals and parents of children with cancer to make well informed, individual decisions concerning CAM.
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Affiliation(s)
- Trine Stub
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 19, 9019, Tromsø, Norway.
| | - Agnete E Kristoffersen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 19, 9019, Tromsø, Norway
| | - Grete Overvåg
- Science and Health Library, UiT The Arctic University of Norway, Hansine Hansens veg 19, 9019, Tromsø, Norway
| | - Miek C Jong
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 19, 9019, Tromsø, Norway
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Ijaz N. Paradigm-Specific Risk Conceptions, Patient Safety, and the Regulation of Traditional and Complementary Medicine Practitioners: The Case of Homeopathy in Ontario, Canada. FRONTIERS IN SOCIOLOGY 2020; 4:89. [PMID: 33869409 PMCID: PMC8022581 DOI: 10.3389/fsoc.2019.00089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/26/2019] [Indexed: 06/12/2023]
Abstract
While the principle of risk reduction increasingly underpins health professional regulatory models across the globe, concepts of risk are neither static nor epistemically neutral. Conventional biomedicine's risk conceptions are substantially rooted in principles of scientific materialism, while many traditional and complementary medicine systems have vitalistic epistemic underpinnings that give rise to distinctive safety considerations. The statutory regulation of traditional and complementary medicine providers has been identified by the World Health Organization as a strategy for enhancing public safety. However, complex risk-related questions arise at the intersection of medical epistemologies whose concepts are at best overlapping, and at worst incommensurable. Elaborating a theoretical concept of "paradigm-specific risk conceptions," this work employs Bacchi's poststructural mode of policy analysis ("What's the Problem Represented to Be?") to critically analyze risk discourse in government documents pertaining to the 2015 statutory regulation of homeopathic practitioners in Ontario, Canada. The Ontario government's pre-regulatory risk assessments of the homeopathic occupation discursively emphasized cultural safety principles alongside homeopathy-specific risk conceptions. These paradigm-specific concepts, rooted in homeopathy's epistemic vitalism, extend beyond materialist constructions of adverse events and clinical omission to address potential harms from homeopathic "proving symptoms", "aggravation," and "disruption," all considered implausible from a biomedical standpoint. Although the province's new homeopathy regulator subsequently articulated safety competencies addressing such vitalistic concepts, the tangible risk management strategies ultimately mandated for practitioners exclusively addressed risks consistent with the scientific materialist paradigm. This policy approach substantially echoes the implicit biomedical underpinnings evident in Ontario's broader legislative context, but leaves a significant policy gap regarding the primary safety considerations originally articulated as substantiation for homeopathy's statutory regulation. To optimally preserve patient safety and full informed consent, regulators of traditional and complementary medicine professionals should favor a pragmatic, epistemically-inclusive approach that actively negotiates paradigm-specific risk conceptions from both biomedicine and the occupation under governance.
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19
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Rutten LA. Homeopathy instead of antibiotics in Respiratory Tract Infections: Certainly less harmful, possibly more effective. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.revhom.2019.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schallock H, Bartmann B, Keinki C, Huebner J. Online information on oncologists' and non-medical practitioners' websites in Germany: A critical comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:2038-2048. [PMID: 31147090 DOI: 10.1016/j.pec.2019.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To survey websites of oncologists and non-medical practitioners (NMPs) in Germany regarding range of treated symptoms, diagnostic tools and therapies offered to cancer patients as well as the quality of websites. METHODS Analysis of 98 websites of oncologists and NMPs was conducted between April and July 2018 with a standardized tool. RESULTS Range of diagnostic and therapeutic methods was high and differed between both groups. Many NMPs (65.3%) intended to support conventional therapy rather than to treat cancer. Most oncologists (85.7%) did not mention the role of complementary and alternative medicine (CAM). Texts on oncologists' websites, showed high complexity according to readability analysis using LIX score as opposed to those on NMPs websites that showed medium complexity. Only small difference of quality of websites between both groups could be detected. CONCLUSION Methods not acknowledged by evidence-based medicine as well as methods at risk for interaction with conventional cancer therapy but also treatment offers with potential benefits for cancer patients were found on NMPs websites. PRACTICE IMPLICATIONS As evidence-based CAM methods can be a useful support of cancer treatment, risk of herb drug interactions can be minimized by oncologists offering reasonable CAM.
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Affiliation(s)
- Henriette Schallock
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Berit Bartmann
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Christian Keinki
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Jutta Huebner
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
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Lombardi N, Crescioli G, Bettiol A, Menniti-Ippolito F, Maggini V, Gallo E, Mugelli A, Vannacci A, Firenzuoli F. Safety of complementary and alternative medicine in children: A 16-years retrospective analysis of the Italian Phytovigilance system database. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 61:152856. [PMID: 31035051 DOI: 10.1016/j.phymed.2019.152856] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Dietary supplements and homeopathic medicines are largely used in children as complementary and alternative medicine (CAM) to treat different health conditions. Safety of CAM is unknown when they are marketed. This study analysed suspected CAM-related adverse reaction (AR) in pediatric population. METHODS The Italian Phytovigilance system was searched for reports of suspected AR related to CAM use in children (0-18 years) from 2002 to 2018. AR reports were evaluated and information about patient's demographic characteristics, suspected CAM, conventional medications, and ARs were collected. In particular, we evaluated whether patient's and CAM characteristics, and concomitant drugs could be potential predictors of ARs seriousness. RESULTS We evaluated 206 pediatric CAM-related AR reports, of which 69 were serious. Patients were mostly treated with only one CAM (n = 193), and 39% of AR reports were related to products containing 2-5 components. Most reported ARs were related to dietary supplements (57.18%), and skin and subcutaneous tissue disorders (40.29%) were the most involved System Organ Class. CAM-related AR reported as serious were higher in subjects exposed to homeopathic medicines (ROR 3.13 [1.88-5.22]), to CAM in presence of concomitant medications (ROR 1.77 [1.01-3.10]), to CAM containing 2-4 components (ROR 2.18 [1.13-4.22]), and to more than three concomitant CAM (ROR 7.81 [1.97-32.69]). CONCLUSION We provide new insights on factors that might increase the risk of serious AR associated with CAM use in children: products containing more than two components and simultaneously administered with conventional medications can represent a potential risk in children.
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Affiliation(s)
- Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy
| | - Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy
| | - Alessandra Bettiol
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy
| | | | - Valentina Maggini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, Florence, Italy
| | - Eugenia Gallo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, Florence, Italy
| | - Alessandro Mugelli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy.
| | - Fabio Firenzuoli
- Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, Florence, Italy
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Antonelli M, Donelli D. Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:824-847. [PMID: 30456773 DOI: 10.1111/hsc.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/10/2018] [Accepted: 10/12/2018] [Indexed: 06/09/2023]
Abstract
Homoeopathy is widespread, and users claim to benefit from it. However, clear evidence of its efficacy over placebo is not available to date. As a consequence, a social separation between homoeopathy users and mainstream medicine exists, exposing these patients to many risks. Our primary objective is to assess homoeopathy efficacy by systematically reviewing existing systematic reviews and meta-analyses and to systematically review trials on open-label placebo (OLP) treatments. A secondary objective is to understand if homoeopathy as a whole may be considered as a placebo treatment. PubMed/Medline, Embase, Google Scholar, and Cochrane Library were systematically searched for systematic reviews and meta-analyses on homoeopathy efficacy, and 61 studies were included. Same databases plus Journal of Interdisciplinary Placebo Studies (JIPS) were also systematically searched for randomised controlled trials (RCTs) on OLP treatments, and 10 studies were included. Databases were searched up to 24 February 2018. Two authors independently screened all retrieved articles and selected studies eligible for inclusion. The quality of reviews of included studies was evaluated with a dedicated NIH tool in the first review, whereas the risk of bias of trials of included studies was assessed with the specific Cochrane tool in the second review. Qualitative syntheses show that homoeopathy efficacy can be considered comparable to placebo, and that OLP treatments may be effective in some health conditions. Placebo effects like placebo itself, treatment context, physician-patient relationship, and other nonspecific factors can define the idea of placebo treatments, which may be effective in some conditions. If homoeopathy efficacy is comparable to placebo, and if placebo treatments can be effective in some conditions, then homoeopathy as a whole may be considered as a placebo treatment. Reinterpreting homoeopathy as a placebo treatment would define limits and possibilities of this practice. This perspective shift suggests a strategy to manage patients who seek homoeopathic care and to reconcile them with mainstream medicine in a sustainable way.
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Affiliation(s)
- Michele Antonelli
- Department of Medicine and Surgery, Institute of Public Health, University of Parma, Parma, Italy
- Terme di Monticelli, Parma, Italy
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Philips CA, Augustine P, Paramaguru R, Ahamed R. Homeopathy-medicine induced severe alcoholic hepatitis. BMJ Case Rep 2019; 12:12/5/e229627. [PMID: 31142491 DOI: 10.1136/bcr-2019-229627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We present a teetotaler with compensated non-alcoholic fatty-liver-disease related cirrhosis who presented with acute worsening of his chronic liver disease. The acute event was not discernible even after extensive work up and finally a transjugular liver biopsy revealed features suggestive of severe alcoholic hepatitis. The patient and the family denied occult alcohol use when questioned over multiple times and finally, the culprit 'alcohol' was found to be the homoeopathy medicines that the patient was consuming over a month for treatment of Gilbert's syndrome. We retrieved and tested the homoeopathy drug for alcohol content and found an alarming 18% ethanol in the same, confirming our diagnosis.
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Affiliation(s)
| | - Philip Augustine
- Gastroenterology, Ernakulam Medical Centre, Kochi, Kerala, India
| | | | - Rizwan Ahamed
- Gastroenterology, Ernakulam Medical Centre, Kochi, Kerala, India
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Rutten LLB. Proving non-conventional methods: A paradigmatic paradox. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2019. [DOI: 10.4103/ijrh.ijrh_64_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ricklefs I, Hohmann-Ebbers M, Herz A, Kopp MV. Use of complementary and alternative medicine in children with asthma. Pediatr Allergy Immunol 2018; 29:326-328. [PMID: 29336063 DOI: 10.1111/pai.12863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Isabell Ricklefs
- Department of Pediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Michelle Hohmann-Ebbers
- Department of Pediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Luebeck, Germany
| | - Alexander Herz
- Department of Pediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Matthias V Kopp
- Department of Pediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
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Sibbritt DW, Leach M, Chang S, Sundberg T, Cramer H, Lauche R, Adams J. Health care utilization among young Australian women with severe tiredness: Results from the Australian Longitudinal Study on Women's Health (ALSWH). Health Care Women Int 2017; 38:983-995. [PMID: 28574747 DOI: 10.1080/07399332.2017.1337773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this article, we explore the use of health services and self-prescribed treatments among 8088 young Australian women with severe tiredness. Data were obtained from the Australian Longitudinal Study on Women's Health. The prevalence of severe tiredness was 49.2%. The frequency of visits to healthcare practitioners was greater among women who sought help for their severe tiredness, compared to women who did not seek help for their severe tiredness or who did not report severe tiredness. Given the impact of this health problem on Australian women, we call for further research on the optimal treatment for severe tiredness.
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Affiliation(s)
- David W Sibbritt
- a Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) , Faculty of Health, University of Technology Sydney , Sydney , New South Wales , Australia
| | - Matthew Leach
- b School of Nursing and Midwifery , University of South Australia , Adelaide , South Australia , Australia
| | - Sungwon Chang
- a Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) , Faculty of Health, University of Technology Sydney , Sydney , New South Wales , Australia
| | - Tobias Sundberg
- c Research Group for Studies of Integrative Health Care , Karolinska Institutet , Solna , Sweden
| | - Holger Cramer
- d Department of Internal and Integrative Medicine , Kliniken Essen-Mitte, University of Duisburg-Essen , Essen , Germany
| | - Romy Lauche
- d Department of Internal and Integrative Medicine , Kliniken Essen-Mitte, University of Duisburg-Essen , Essen , Germany
| | - Jon Adams
- a Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) , Faculty of Health, University of Technology Sydney , Sydney , New South Wales , Australia
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Ebert F, Staufenbiel R, Simons J, Pieper L. Randomized, blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows. J Dairy Sci 2017; 100:4857-4867. [PMID: 28342609 DOI: 10.3168/jds.2016-11805] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 01/27/2017] [Indexed: 12/22/2022]
Abstract
Mastitis is one of the most common diseases in dairy production, and homeopathic remedies have been used increasingly in recent years to treat it. Clinical trials evaluating homeopathy have often been criticized for their inadequate scientific approach. The objective of this triple-blind, randomized controlled trial was to assess the efficacy of homeopathic treatment in bovine clinical mastitis. The study was conducted on a conventionally managed dairy farm between June 2013 and May 2014. Dairy cows with acute mastitis were randomly allocated to homeopathy (n = 70) or placebo (n = 92), for a total of 162 animals. The homeopathic treatment was selected based on clinical symptoms but most commonly consisted of a combination of nosodes with Streptococcinum, Staphylococcinum, Pyrogenium, and Escherichia coli at a potency of 200c. Treatment was administered to cows in the homeopathy group at least once per day for an average of 5 d. The cows in the placebo group were treated similarly, using a placebo preparation instead (lactose globules without active ingredients). If necessary, we also used allopathic drugs (e.g., antibiotics, udder creams, and anti-inflammatory drugs) in both groups. We recorded data relating to the clinical signs of mastitis, treatment, time to recovery, milk yield, somatic cell count at first milk recording after mastitis, and culling. We observed cows for up to 200 d after clinical recovery. Base-level data did not differ between the homeopathy and placebo groups. Mastitis lasted for an average of 6 d in both groups. We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo. The advantages or disadvantages of homeopathy should be carefully assessed for individual farms.
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Affiliation(s)
| | | | | | - Laura Pieper
- Ruminant and Swine Clinic; Institute for Veterinary Epidemiology and Biostatistics, Free University of Berlin, 14163 Berlin, Germany.
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Cabut S, Marie C, Vendittelli F, Sauvant-Rochat MP. Intended and actual use of self-medication and alternative products during pregnancy by French women. J Gynecol Obstet Hum Reprod 2017; 46:167-173. [DOI: 10.1016/j.jogoh.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 11/16/2022]
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Mathie RT, Roberts ER, Rutten ALBL. Adverse effects of homeopathy: we clearly need more details. Complement Ther Med 2016; 29:235. [PMID: 27912952 DOI: 10.1016/j.ctim.2016.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 05/25/2016] [Indexed: 11/25/2022] Open
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Gupta HR, Patil Y, Singh D, Thakur M. Embryonic Zebrafish Model - A Well-Established Method for Rapidly Assessing the Toxicity of Homeopathic Drugs: - Toxicity Evaluation of Homeopathic Drugs Using Zebrafish Embryo Model. J Pharmacopuncture 2016; 19:319-328. [PMID: 28127503 PMCID: PMC5241443 DOI: 10.3831/kpi.2016.19.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Advancements in nanotechnology have led to nanoparticle (NP) use in various fields of medicine. Although the potential of NPs is promising, the lack of documented evidence on the toxicological effects of NPs is concerning. A few studies have documented that homeopathy uses NPs. Unfortunately, very few sound scientific studies have explored the toxic effects of homeopathic drugs. Citing this lack of high-quality scientific evidence, regulatory agencies have been reluctant to endorse homeopathic treatment as an alternative or adjunct treatment. This study aimed to enhance our insight into the impact of commercially-available homeopathic drugs, to study the presence of NPs in those drugs and any deleterious effects they might have, and to determine the distribution pattern of NPs in zebrafish embryos (Danio rerio). METHODS Homeopathic dilutions were studied using high-resolution transmission electron microscopy with selected area electron diffraction (SAED). For the toxicity assessment on Zebrafish, embryos were exposed to a test solution from 4 - 6 hours post-fertilization, and embryos/larvae were assessed up to 5 days post-fertilization (dpf) for viability and morphology. Toxicity was recorded in terms of mortality, hatching delay, phenotypic defects and metal accumulation. Around 5 dpf was found to be the optimum developmental stage for evaluation. RESULTS The present study aimed to conclusively prove the presence of NPs in all high dilutions of homeopathic drugs. Embryonic zebrafish were exposed to three homeopathic drugs with two potencies (30CH, 200CH) during early embryogenesis. The resulting morphological and cellular responses were observed. Exposure to these potencies produced no visibly significant malformations, pericardial edema, and mortality and no necrotic and apoptotic cellular death. CONCLUSION Our findings clearly demonstrate that no toxic effects were observed for these three homeopathic drugs at the potencies and exposure times used in this study. The embryonic zebrafish model is recommended as a well-established method for rapidly assessing the toxicity of homeopathic drugs.
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Affiliation(s)
- Himanshu R Gupta
- Department of Medical Genetics, MGMIUDBS, Mahatma Gandhi Mission Institute of Health Sciences, Kamothe, Navi Mumbai, India
| | - Yogesh Patil
- MGMCET & Central Research Laboratory, Mahatma Gandhi Mission Institute for Health Sciences, Kamothe, Navi Mumbai, India
| | - Dipty Singh
- National Centre for Preclinical Reproductive and Genetic Toxicology (NIRRH), National Institute of Research in Reproductive Health (ICMR), Jehangir Merwanji Street, Parel, Mumbai, India
| | - Mansee Thakur
- Mahatma Gandhi Mission College of Engineering and Technology & Department of Medical Biotechnology, Central Research Laboratory, MGM Medical College, MGMIHS, Kamothe, Navi Mumbai, India
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Steel A, Cramer H, Leung B, Lauche R, Adams J, Langhorst J, Dobos G. Characteristics of Homeopathy Users among Internal Medicine Patients in Germany. FORSCHENDE KOMPLEMENTARMEDIZIN (2006) 2016; 23:284-289. [PMID: 27811465 DOI: 10.1159/000450818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Homeopathy use continues to grow in many European countries, and some studies have examined the characteristics of patients using homeopathy within the general population. The aim of this study was to identify predictors for homeopathy use among internal medicine patients. PATIENTS AND METHODS A cross-sectional analysis was conducted among all patients being referred to the Department of Internal and Integrative Medicine at Essen, Germany, over a 3-year period. The analysis examined whether patients had used homeopathy for their primary medical complaint before, the perceived benefit, and the perceived harm of homeopathy use. Odds ratios with 95% confidence intervals were calculated using multiple logistic regression analysis. RESULTS Of 2,045 respondents, 715 (35.0%) reported having used homeopathy for their primary medical complaint (diagnosis according to the International Statistical Classification of Diseases and Related Health Problems), with 359 (50.2%) reporting perceived benefits and 15 (2.1%) reporting harm. Homeopathy use was positively associated with female gender, high school level education, suffering from fibromyalgia or subthreshold depression, and being fast food abstinent, while patients with osteoarthritis, spinal or other pain, smokers, and patients with a high external-social health locus of control were less likely to use homeopathy. CONCLUSION Personal characteristics and health status may impact on the use and the perceived helpfulness of homeopathy.
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Affiliation(s)
- Amie Steel
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
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Kim HJ, Jeon B, Chung SJ. Professional ethics in complementary and alternative medicines in management of Parkinson's disease. JOURNAL OF PARKINSON'S DISEASE 2016; 6:675-683. [PMID: 27589539 PMCID: PMC5088405 DOI: 10.3233/jpd-160890] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/27/2022]
Abstract
The practice of complementary and alternative medicine (CAM) is not, at present, considered an integral part of conventional medicine. As the popularity of CAM grows and access to information about CAM increases through the media and internet where CAMs are often promoted, patients are at risk of exposure unvalidated information. Therefore, there is a need for physicians to examine objectively the efficacy and safety of CAM, compare it with current medications, and become actively involved in the CAM treatment with patients. In accordance with these needs, this manuscript reviews the utility, scientific evidence, safety and cost-effectiveness of CAM in the treatment of Parkinson's disease (PD). We also address the ethical issues of CAM practices.
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Affiliation(s)
- Hee Jin Kim
- Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
- Parkinson Disease Study Group, Seoul National University Hospital, Seoul, South Korea
| | - Beomseok Jeon
- Parkinson Disease Study Group, Seoul National University Hospital, Seoul, South Korea
- Department of Neurology and Movement Disorder Center, College of Medicine, Seoul National University, Seoul, South Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Dietrich DR, Dekant W, Greim H, Heslop-Harrison P, Berry SC, Boobis A, Hengstler J, Sharpe R. Allowing pseudoscience into EU risk assessment processes is eroding public trust in science experts and in science as a whole: The bigger picture. Chem Biol Interact 2016; 257:1-3. [DOI: 10.1016/j.cbi.2016.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stub T, Musial F, Kristoffersen AA, Alræk T, Liu J. Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2016; 26:146-63. [DOI: 10.1016/j.ctim.2016.03.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 03/08/2016] [Accepted: 03/21/2016] [Indexed: 10/22/2022] Open
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Tournier AL, Roberts ER. Cutting Edge Research in Homeopathy: HRI's second international research conference in Rome. HOMEOPATHY 2016; 105:3-7. [PMID: 26827995 DOI: 10.1016/j.homp.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rome, 3rd-5th June 2015, was the setting for the Homeopathy Research Institute's (HRI) second conference with the theme 'Cutting Edge Research in Homeopathy'. Attended by over 250 delegates from 39 countries, this event provided an intense two and a half day programme of presentations and a forum for the sharing of ideas and the creation of international scientific collaborations. With 35 oral presentations from leaders in the field, the scientific calibre of the programme was high and the content diverse. This report summarises the key themes underpinning the cutting edge data presented by the speakers, including six key-note presentations, covering advancements in both basic and clinical research. Given the clear commitment of the global homeopathic community to high quality research, the resounding success of both Barcelona 2013 and Rome 2015 HRI conferences, and the dedicated support of colleagues, the HRI moves confidently forward towards the next biennial conference.
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Kim S, Chung SE, Lee S, Park J, Choi S, Kim S. Experience of complementary and alternative medicine in patients with amyotrophic lateral sclerosis and their families: A qualitative study. Amyotroph Lateral Scler Frontotemporal Degener 2016; 17:191-7. [PMID: 26735587 DOI: 10.3109/21678421.2015.1125504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to explore the life experience related to complementary and alternative medicine (CAM) use among patients with amyotrophic lateral sclerosis (ALS). Data were collected though semi-structured interviews of nine patients with ALS and seven family members, who have used CAM. Audio recordings of the interviews were transcribed verbatim and checked for accuracy. The Giorgi's method of phenomenology was used for data analysis. Five constituents forming the units of meaning were: facing the limits of conventional medicine; getting to know CAM; recognizing the ineffectiveness of CAM; using CAM for symptomatic treatment; and seeking new CAM endlessly for complete cure. The study results provide an in-depth understanding of experience with CAM among patients with ALS and their family members. Healthcare providers must give accurate information about the efficacy of CAM as well as its safety and possible adverse effects and should offer patient-centred treatment through active communication throughout the process of diagnosis and treatment.
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Affiliation(s)
- Sungha Kim
- a Korean Medicine Life Science, University of Science and Technology , Daejeon .,b Korea Medicine Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon
| | - Seung Eun Chung
- c Department of Nursing , Korea National University of Transportation , Jeungpyeong-gun , and
| | - Sanghun Lee
- a Korean Medicine Life Science, University of Science and Technology , Daejeon .,b Korea Medicine Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon
| | - Jeonghwan Park
- b Korea Medicine Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon
| | - Sunmi Choi
- a Korean Medicine Life Science, University of Science and Technology , Daejeon .,b Korea Medicine Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon
| | - Sungchul Kim
- d Department of Acupuncture & Moxibustion , Wonkwang University Gwangju Medical Hospital , Gwangju , Republic of Korea
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Walach H. Die Zukunft der Homöopathie. Complement Med Res 2016; 23:212-4. [DOI: 10.1159/000448970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Sacristán Rubio A, Torres Jiménez JI. Homeopatía, una realidad social y asistencial. Aten Primaria 2015; 47:469-70. [PMID: 25843946 PMCID: PMC6983682 DOI: 10.1016/j.aprim.2015.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/17/2015] [Indexed: 11/24/2022] Open
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Stub T, Kristoffersen AE, Alræk T, Musial F, Steinsbekk A. Risk in homeopathy: Classification of adverse events and homeopathic aggravations--A cross sectional study among Norwegian homeopath patients. Complement Ther Med 2015; 23:535-43. [PMID: 26275646 DOI: 10.1016/j.ctim.2015.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 06/04/2015] [Accepted: 06/04/2015] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED The registration of adverse events is important to identify treatment that might impose risk to patients. Homeopathic aggravation, a concept unique for homeopathy may impose a particular risk, as it is tolerant towards a worsening of the patients' symptoms. The aim of this study was to explore the classification of patient reported reactions as homeopathic aggravations or adverse drug reactions. DESIGN AND SETTING In a cross sectional survey, patients were asked to register any reactions they had experienced 14 days after taking homeopathic remedies. Worsening of symptoms was classified as homeopathic aggravation if it was (i) an increase of the patients' existing symptoms (ii) and/or a feeling of well-being that emerged 1-3 days after taking the remedy (iii) and/or headache and/or fatigue accompanying these symptoms. RESULTS A total of 26% of the participants reported worsening of symptoms. One third was classified as adverse events. Half of these were graded as minor and the other half as moderate according to the Common Terminology Criteria for Adverse Events. Two thirds were classified as homeopathic aggravations. Of these, 73% were classified as minor and 27% as moderate, giving a tendency towards milder severity for those classified as homeopathic aggravations (p=0.065). CONCLUSION Patients reported a substantial part of the short-term reactions after taking homeopathic remedy as a worsening of symptoms. These reactions were classified as mild and moderate. Hence, the risk connected to homeopathic treatment is minor. More studies are needed to confirm the existence of homeopathic aggravation and how to classify the concept in a clinically meaningful way.
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Affiliation(s)
- Trine Stub
- The National Research Center in Complementary and Alternative Medicine (NAFKAM) Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Agnete E Kristoffersen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM) Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Terje Alræk
- The National Research Center in Complementary and Alternative Medicine (NAFKAM) Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Frauke Musial
- The National Research Center in Complementary and Alternative Medicine (NAFKAM) Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Aslak Steinsbekk
- Norwegian University of Science and Technology, Department of Public Health and General Practice, Trondheim, Norway
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Levy D, Gadd B, Kerridge I, Komesaroff PA. A gentle ethical defence of homeopathy. JOURNAL OF BIOETHICAL INQUIRY 2015; 12:203-209. [PMID: 25037244 DOI: 10.1007/s11673-014-9563-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 12/22/2013] [Indexed: 06/03/2023]
Abstract
Recent discourses about the legitimacy of homeopathy have focused on its scientific plausibility, mechanism of action, and evidence base. These, frequently, conclude not only that homeopathy is scientifically baseless, but that it is "unethical." They have also diminished patients' perspectives, values, and preferences. We contend that these critics confuse epistemic questions with questions of ethics, misconstrue the moral status of homeopaths, and have an impoverished idea of ethics-one that fails to account either for the moral worth of care and of relationships or for the perspectives, values, and preferences of patients. Utilitarian critics, in particular, endeavour to present an objective evaluation-a type of moral calculus-quantifying the utilities and disutilities of homeopathy as a justification for the exclusion of homeopathy from research and health care. But these critiques are built upon a narrow formulation of evidence and care and a diminished episteme that excludes the values and preferences of researchers, homeopaths, and patients engaged in the practice of homeopathy. We suggest that homeopathy is ethical as it fulfils the needs and expectations of many patients; may be practiced safely and prudentially; values care and the virtues of the therapeutic relationship; and provides important benefits for patients.
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Affiliation(s)
- David Levy
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, Faculty of Medicine, University of Sydney, 92-94 Parramatta Rd., Camperdown, NSW, 2006, Australia,
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Stub T, Salamonsen A, Kristoffersen A, Musial F. How to handle worsening of condition during treatment - risk assessment in homeopathic practice. Complement Med Res 2015; 22:30-5. [PMID: 25824402 DOI: 10.1159/000377644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Even though homeopathy is regarded as a harmless intervention, homeopathic practice may not be entirely risk-free. Risk in homeopathy can be divided into direct and indirect risk. Direct risk refers to traditional adverse effects of an intervention; indirect risk is related to adverse effects in a treatment context, e.g. the practitioner. Available data suggest that the risk profile of homeopathic remedies in ultra-molecular potencies is minor, but there is a potential for indirect risk related to homeopathic practice. The concept of 'homeopathic aggravation' which is unique for homeopathy may impose a particular risk as it allows the health status of the patients to deteriorate before there is a possible improvement. In that respect it is imperative to distinguish homeopathic aggravations from adverse effects. In a general risk evaluation of the homeopathic treatment it may be useful to assess the patient's symptoms in accordance with the natural course of disease and to evaluate any negative deviation from the normal curve as a possible adverse effect of the treatment. It is imperative that more emphasis is placed on patient safety during the education in homeopathy, and that students are trained to identify serious and red flag situations.
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Affiliation(s)
- Trine Stub
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway
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Bell IR, Sarter B, Koithan M, Banerji P, Banerji P, Jain S, Ives J. Integrative nanomedicine: treating cancer with nanoscale natural products. Glob Adv Health Med 2014; 3:36-53. [PMID: 24753994 PMCID: PMC3921611 DOI: 10.7453/gahmj.2013.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Finding safer and more effective treatments for specific cancers remains a significant challenge for integrative clinicians and researchers worldwide. One emerging strategy is the use of nanostructured forms of drugs, vaccines, traditional animal venoms, herbs, and nutraceutical agents in cancer treatment. The recent discovery of nanoparticles in traditional homeopathic medicines adds another point of convergence between modern nanomedicine and alternative interventional strategies. A way in which homeopathic remedies could initiate anticancer effects includes cell-to-cell signaling actions of both exogenous and endogenous (exosome) nanoparticles. The result can be a cascade of modulatory biological events with antiproliferative and pro-apoptotic effects. The Banerji Protocols reflect a multigenerational clinical system developed by homeopathic physicians in India who have treated thousands of patients with cancer. A number of homeopathic remedy sources from the Banerji Protocols (eg, Calcarea phosphorica; Carcinosin-tumor-derived breast cancer tissue prepared homeopathically) overlap those already under study in nonhomeopathic nanoparticle and nanovesicle tumor exosome cancer vaccine research. Past research on antineoplastic effects of nano forms of botanical extracts such as Phytolacca, Gelsemium, Hydrastis, Thuja, and Ruta as well as on homeopathic remedy potencies made from the same types of source materials suggests other important overlaps. The replicated finding of silica, silicon, and nano-silica release from agitation of liquids in glassware adds a proven nonspecific activator and amplifier of immunological effects. Taken together, the nanoparticulate research data and the Banerji Protocols for homeopathic remedies in cancer suggest a way forward for generating advances in cancer treatment with natural product-derived nanomedicines.
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Affiliation(s)
- Iris R Bell
- Department of Family and Community Medicine, The University of Arizona College of Medicine, Tucson (Dr Bell), United States
| | - Barbara Sarter
- Hahn School of Nursing and Health Sciences, University of San Diego, California, and Bastyr University - California (Dr Sarter), United States
| | - Mary Koithan
- College of Nursing, The University of Arizona (Drs Koithan), United States
| | | | - Pratip Banerji
- PBH Research Foundation, Kolkata, India (Drs Banerji), India
| | - Shamini Jain
- Samueli Institute, Alexandria, Virginia (Dr Jain), United States
| | - John Ives
- Samueli Institute, Alexandria, Virginia (Dr Ives), United States
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Piñeiro Pérez R, Madurga Sanz M, de Lucas Collantes C, Cilleruelo Ortega M. Homeopatía y productos dietéticos que no precisan prescripción médica en niños: ¿son siempre inofensivos? An Pediatr (Barc) 2014; 80:e102-3. [DOI: 10.1016/j.anpedi.2013.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 09/16/2013] [Indexed: 11/28/2022] Open
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Chirumbolo S. Adverse effects and homeopathy: may remedies yet contain noxious or toxic molecules? Br J Clin Pharmacol 2013; 78:184-5. [PMID: 24134131 DOI: 10.1111/bcp.12259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 10/03/2013] [Indexed: 12/01/2022] Open
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Lahner E, Bellentani S, Bastiani RD, Tosetti C, Cicala M, Esposito G, Arullani P, Annibale B. A survey of pharmacological and nonpharmacological treatment of functional gastrointestinal disorders. United European Gastroenterol J 2013; 1:385-93. [PMID: 24917987 PMCID: PMC4040767 DOI: 10.1177/2050640613499567] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/08/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Treatment of functional gastrointestinal disorders (FGIDs) is based on symptoms relieve by conventional drugs, but increasingly complementary and alternative medicine (CAM) is used. OBJECTIVE This survey aimed to investigate the current treatments used by FGIDs patients. METHODS A total of 25 Italian gastroenterologists interviewed outpatients on gastrointestinal symptoms and treatments (pharmacological, CAM, diet/dietary supplements) used during the last year to relieve FGIDs. Consecutive adults with FGIDs according to Rome III were included. RESULTS Of the 199 patients, 81% used conventional drugs, 64.3% diet/dietary supplements, and 48.7% CAM. Conventional drugs, diet/dietary supplements, or CAM as exclusive treatment were used by 24.6, 6, and 2.5% of patients, respectively. Two-thirds used more than one treatment: 34.7% conventional drugs, CAM, and diet/dietary supplements, 17.1% conventional drugs and diet/dietary supplements, 10.1% diet and CAM, and 5% conventional drugs and CAM. Benefits and adverse effects were similar for conventional drugs and nonpharmacological treatments. Males (OR 2.4) without lower GI symptoms (OR 5.4) used more frequently exclusive pharmacological treatment of FGIDs. CONCLUSIONS Conventional drugs are the preferred treatment for FGID. CAM and dietary modifications are more likely used as an adjunct to rather than instead of conventional drugs. Adverse effects occurred in all treatments.
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Affiliation(s)
| | - Stefano Bellentani
- Study Group ‘Primary Care in Gastroenterology’, Italian Society of Gastroenterology, Rome, Italy
| | - Rudy De Bastiani
- Study Group ‘Primary Care in Gastroenterology’, Italian Society of Gastroenterology, Rome, Italy
| | - Cesare Tosetti
- Study Group ‘Primary Care in Gastroenterology’, Italian Society of Gastroenterology, Rome, Italy
| | | | | | - Paolo Arullani
- Italian Foundation ‘Aldo Torsoli’ for Digestive, Liver and Pancreatic Diseases, Rome, Italy
| | - Bruno Annibale
- University ‘Sapienza’, Rome, Italy
- Bruno Annibale, Dipartimento medico-chirurgico di scienze cliniche e tecnobiomediche, University Sapienza, Ospedale Sant’Andrea, Via di Grottarossa 1035, 00189 Roma, Italia.
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Chirumbolo S. Bias and adverse effects of homeopathy: is scientific criticism in homeopathy a "mission impossible"? Int J Clin Pract 2013; 67:923-6. [PMID: 23952470 DOI: 10.1111/ijcp.12225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Prevalence of complementary and alternative medicine (CAM) use by menopausal women: A systematic review of surveys. Maturitas 2013; 75:34-43. [DOI: 10.1016/j.maturitas.2013.02.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 02/15/2013] [Indexed: 10/27/2022]
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