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Makarem NN, Brome D, Romani M. Knowledge, attitude, and practices of complementary and alternative medicine: a survey of physicians and nurses at an academic medical center in Beirut. Libyan J Med 2022; 17:2071813. [PMID: 35603591 PMCID: PMC9132421 DOI: 10.1080/19932820.2022.2071813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Nisrine N. Makarem
- Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Dayana Brome
- Psychology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Romani
- Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Daffini L, Pirola I, Saccà G, Salvetti M, Cappelli C. Graves' disease treated by complementary medicine leading to thyroid storm: A case report. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:S371-S375. [PMID: 34760085 PMCID: PMC8559635 DOI: 10.22088/cjim.12.0.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/28/2020] [Accepted: 11/10/2020] [Indexed: 11/17/2022]
Abstract
Background: Thyroid storm is a rare, life-threatening condition characterized by severe clinical manifestations of thyrotoxicosis and can be precipitated by several factors. We described a thyroid storm precipitated by a long-term treatment using homeopathic medicine containing iodine. Case presentation: A 55-year-old Italian woman was admitted to our Sub-Intensive Care Unit with the diagnosis of congestive heart failure and thyrotoxicosis. She has been diagnosed with Graves’ disease two years before; she refused conventional therapy and in the preceding six months had been using phytotherapeutic and homeopathic medicine. We found serum and urine iodine levels consistent with severe intoxication by iodine (serum iodine: 42100 mcg/L and urinary iodine: 4223 mcg/L, respectively). After a few hours, the patient went into cardiac arrest. She was subjected to invasive ventilation, dialyzed with continuous veno-venous hemofiltration and treated with vasoactive amines. Conclusion: The high level of iodemia manifested in our patient - around a thousand times greater than the normal range and itself associated with fatal outcomes - was caused by long-term homeopathic treatment. This long-term treatment has two consequences: first, iodine load-precipitated hyperthyroidism in thyroid storm, and secondly, it prevents us from treating patients with inorganic iodide.
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Affiliation(s)
- Linda Daffini
- Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy
| | - Ilenia Pirola
- Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy
| | | | | | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy
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Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, Madeddu G, Magistri P, Bimonte S, Trovò M, Gnagnarella P, Cuomo A, Cascella M, Lleshi A, Nasti G, Facchini S, Fiorica F, Di Francia R, Nunnari G, Pellicanò GF, Guglielmino A, Danova M, Rossetti S, Amore A, Crispo A, Facchini G. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol 2020; 10:594. [PMID: 32411599 PMCID: PMC7202223 DOI: 10.3389/fonc.2020.00594] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. Methods: A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, to collect personal and professional data and information on attitudes toward CAM and its possible role in Conventional Medicine (CM). Results: Of the 438 participants, most were specialists in oncology (18%), internal medicine (17%), surgery (15%), and radiotherapy (11%). Most worked at university (44%) or research hospitals (31%). Forty-two percent of participants believed that CAM could have an integrative role within CM. Oncologists were the physicians who were best informed on CAM (58%). Physicians working at research institutes or university hospitals had a greater knowledge of CAM than those employed at general hospitals (p < 0.0001), and those who were also involved in research activity had a greater knowledge of CAM than those who were not (p < 0.003). Length of work experience was significantly related to CAM knowledge. Moreover, 55% of participants suggest CAM interventions to their patients and 44% discuss CAM with them. The best-known interventions were acupuncture, Aloe vera and high-dose vitamin C. Conclusion: CAM use by patients with chronic disease and/or cancer has become a topical issue for the scientific community and for physicians. Knowing the reasons that prompt these patients to use CAM and guiding them in their decisions would improve treatment and outcomes and also benefit healthcare systems. Our findings contribute to a greater understanding of CAM knowledge, attitudes, and practice among Italian physicians. Further research is needed to identify the more effective CAM treatments and to work toward an integrated healthcare model.
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Affiliation(s)
- Massimiliano Berretta
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Taibi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Paolo Tralongo
- Division of Medical Oncology, "Umberto I" Hospital, Siracusa, Italy
| | - Alberto Fulvi
- Division of Medical Oncology, "Gemelli" Hospital, Roman, Italy
| | | | - Giordano Madeddu
- Division of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Paolo Magistri
- Department of Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabrina Bimonte
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Trovò
- Division of Radiotherapy, "Santa Maria della Misericordia" Hospital, Udine, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Arturo Cuomo
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Cascella
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Arben Lleshi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Guglielmo Nasti
- Division of Medical Oncology B, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Sergio Facchini
- Department of Urology, University of Naples "Federico II", Naples, Italy
| | | | | | - Giuseppe Nunnari
- Division of Infectious Disease, University of Messina, Messina, Italy
| | | | - Aurelio Guglielmino
- Division of Anaesthesia, Policlinico Universitario, University of Catania, Catania, Italy
| | - Marco Danova
- Department of Internal Medicine and Medical Oncology, Vigevano Civic Hospital, ASST of Pavia, Vigevano, Italy
| | - Sabrina Rossetti
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Alfonso Amore
- Division of Surgery Melanoma and Skin Cancer, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Anna Crispo
- Unit of Epidemiology, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Gaetano Facchini
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
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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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Kristoffersen AE, Stub T, Broderstad AR, Hansen AH. Use of traditional and complementary medicine among Norwegian cancer patients in the seventh survey of the Tromsø study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:341. [PMID: 31783842 PMCID: PMC6884826 DOI: 10.1186/s12906-019-2762-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/19/2019] [Indexed: 12/12/2022]
Abstract
Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment and is rarely discussed with conventional health care providers, increasing the risk of negative interaction with conventional cancer care. The aim of this study was to investigate the use of T&CM among cancer patients in Tromsø, and to investigate the differences in T&CM use between people living with cancer, people with cancer previously, and people without a history of cancer. Method Data was drawn from the seventh survey of the Tromsø study conducted in 2015–2016. All inhabitants of Tromsø aged 40 and above were invited to participate (n = 32,591) of whom n = 21,083 accepted the invitation (response rate 65%). Data was collected thorough three self-administered questionnaires and a comprehensive clinical examination. Pearson chi-square tests, Fisher exact tests and one-way ANOVA tests were used to describe differences between the groups while binary logistic regressions were used for adjusted values. Results Eight percent of the participants (n = 1636) reported to have (n = 404) or have had (n = 1232) cancer. Of the participants with cancer at present 33.4% reported use of T&CM within the last year, 13.6% had consulted a T&CM provider, 17.9% had used herbal medicine/natural remedies and 6.4% had practiced self-help techniques. The participants with cancer at present were more likely to have visited a T&CM provider than participants with cancer previously (13.6% vs. 8.7%, p = 0.020). Among the participants with cancer at present, 6.4% reported to have consulted a TM provider, 5.8% had consulted an acupuncturist, while 4.7% had consulted other CM providers. Women were significantly more likely than men to have used acupuncture and self-help techniques. No significant gender differences were found regarding visits to other CM providers, TM providers nor use of herbal medicine/natural remedies. Conclusion The findings are in line with previous research suggesting that both men and women use TM complementary to other CM modalities outside the official health care system. As herbal medicine might interact with conventional cancer treatment, health care providers need to discuss such use with their patients.
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Nothnagel H, Brown Menard M, Kvarstein G, Norheim AJ, Weiss T, Puta C, Mist SD, Musial F. Recruitment and inclusion procedures as "pain killers" in clinical trials? J Pain Res 2019; 12:2027-2037. [PMID: 31308731 PMCID: PMC6614587 DOI: 10.2147/jpr.s204259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/24/2019] [Indexed: 02/05/2023] Open
Abstract
Background Recruitment and inclusion procedures in clinical trials are time critical. This holds particularly true for studies investigating patients with fluctuating symptom patterns, like those with chronic neck pain. In a feasibility study on neck pain, we found a clinically relevant decrease in pain ratings within the recruitment period. This paper analyses the phenomenon and gives recommendations for recruitment procedures in clinical trials on pain. Methods Changes in pain intensity scores of 44 chronic neck pain patients (6 males and 36 females; mean age: 45.3±13.2 years) between the first telephone contact and baseline assessment were analyzed. Inclusion criterion was a mean pain intensity of ≥40 on a 0-100 numerical rating scale during the last three months. Statistical analyses were performed using ANOVA and parametric/non-parametric correlation coefficients. Results Average pain intensity score decreased significantly from 60.3±13.3 at telephone interview to 38.1±21.7 at baseline assessment. This represents a relative change of 36.8%. A weak but significant negative correlation was found between number of days between assessments and pain rating differences. There was a positive correlation between change of pain intensity and the pain level at the first contact, indicating that the decreased pain ratings over time were also dependent on the initial pain rating. Conclusions The clinically significant changes in pain intensity were weakly related to waiting time and moderately dependent on initial pain intensity, suggesting regression to the mean. The natural course of the disease and the Hawthorne effect are also discussed as contributing factors.
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Affiliation(s)
- H Nothnagel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Department of Community Medicine, The National Research Center for Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
| | - M Brown Menard
- Crocker Institute, Kiawah Island, SC, USA.,School of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA, USA
| | - G Kvarstein
- Pain clinic, University Hospital of Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway
| | - A J Norheim
- Department of Community Medicine, The National Research Center for Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
| | - T Weiss
- Department of Biological and Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - C Puta
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany.,Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Friedrich Schiller University, Jena, Germany
| | - S D Mist
- Oregon Health & Science University, Portland, OR, USA
| | - F Musial
- Department of Community Medicine, The National Research Center for Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
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Risvoll H, Giverhaug T, Halvorsen KH, Waaseth M, Musial F. Direct and indirect risk associated with the use of dietary supplements among persons with dementia in a Norwegian memory clinic. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:261. [PMID: 28494750 PMCID: PMC5427606 DOI: 10.1186/s12906-017-1765-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 04/28/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of dietary supplements (DS) is common among persons with dementia. Direct risks associated with DS use include adverse events and DS-drug interactions. A direct risk is a risk caused by the treatment itself. Indirect risks are related to the treatment setting, such as the conditions of use, and not to the treatment itself. Because dementia symptoms may reduce a person's ability to cope with the administration of DS, the use of DS may pose a threat to safety as an indirect risk. The aim of this study was to describe the extent of DS use among persons with dementia in ambulatory care and to identify some relevant direct and indirect risks related to DS use. METHODS We conducted a survey among 151 persons with dementia attending an outpatient memory clinic in Northern Norway. Study measurements included: the participants' characteristics, cognitive functioning, functioning in the activities of daily living (ADL), and the use of DS and prescription drugs (PD). We assessed direct risks by evaluating potential DS-drug interactions and indirect risks by evaluating the conditions under which it was used. RESULTS Forty-six percent (n = 70) of the persons with dementia used DS. Ninety-seven percent (n = 147) used PD. We found potentially clinically relevant DS-drug interactions representing a direct risk in eight persons with dementia (11% of users). While only 36% (n = 26) of the participants received assistance with the administration of DS, 73% (n = 106) received assistance with the administration of PD. Persons with dementia living alone were at risk of not receiving assistance, as home care service seldom was involved in DS administration. Data indicated that assistance with DS administration was not provided for all persons with dementia in need, representing an indirect risk to these persons. Only one-third of the persons with dementia and half of the caregivers were aware of the general risks of adverse events and interactions associated with the use of DS. CONCLUSIONS Persons with dementia use DS frequently, yet DS use may be associated with direct and indirect risks to patient safety as potentially clinically relevant interactions were discovered and DS intake often was unsupervised.
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Affiliation(s)
- Hilde Risvoll
- NKS Kløveråsen AS, Junkernveien 67, 8076, Bodø, Norway
- RELIS North Norway, University Hospital North Norway, Sykehusvegen 38, 9019 Tromsø, Norway
| | - Trude Giverhaug
- RELIS North Norway, University Hospital North Norway, Sykehusvegen 38, 9019 Tromsø, Norway
| | - Kjell H. Halvorsen
- Department of Pharmacy, UiT The Arctic University of Norway, pb 6050 Langnes, 9037 Tromsø, Norway
| | - Marit Waaseth
- Department of Pharmacy, UiT The Arctic University of Norway, pb 6050 Langnes, 9037 Tromsø, Norway
| | - Frauke Musial
- NAFKAM, UiT The Arctic University of Norway, pb 6050 Langnes, 9037 Tromsø, Norway
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Stub T, Quandt SA, Arcury TA, Sandberg JC, Kristoffersen AE, Musial F, Salamonsen A. Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:353. [PMID: 27609097 PMCID: PMC5016861 DOI: 10.1186/s12906-016-1326-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 08/25/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. METHODS Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. RESULTS Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. CONCLUSION The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks.
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Affiliation(s)
- Trine Stub
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC 27157 USA
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
- Present address: Department of Community Medicine, The National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC 27157 USA
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Joanne C. Sandberg
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Agnete E. Kristoffersen
- Department of Community Medicine, The National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
| | - Frauke Musial
- Department of Community Medicine, The National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
| | - Anita Salamonsen
- Department of Community Medicine, The National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, Tromsø, Norway
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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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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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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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