1 Primary Care, University of Bristol, Bristol, UK
2 Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
Most published case reports are retrospective, rely on the memory of the prescriber and vary in the detail of follow-up provided. Though valued by practitioners, they are not sufficiently systematic to be considered part of the evidence base for homeopathy. On the other hand rigorous scientific studies such as clinical trials do not reflect the realities of daily practice. In this presentation we aim to demonstrate the power of the formal case study (1) to investigate both process and outcome in homeopathy.
For several months every patient referred to the Bristol Homeopathic Hospital and living with the diagnoses of either chronic fatigue, IBS or eczema was offered the opportunity to join the study. Recruitment continued until we had six patients in each category. Patients were interviewed before and after a course of five homeopathic consultations with one of three homeopathic physicians over eight months. All interviews and consultations were recorded and transcribed. We additionally tracked outcome using condition-specific and generic outcome scores, reports from “significant others” and pictures drawn by the patients.
All but one patient completed their course of treatment. About one third had substantial health gain, one third were helped and one third were not helped. Homeopathic phenomena documented included aggravations, return of old symptoms and examples of Hering’s Law. We have characterised many other aspects of the process, such as the doctor-patient relationship and patient expectations that have a bearing on outcome.
These cases provide a naturalistic account of patients under routine homeopathic care based on verifiable prospectively obtained data. As such they open up a new approach to studying the process and outcome of homeopathic care. Formal case studies can be used by homeopaths to study Materia Medica and real-world case management and by researchers in the appropriate design of larger studies. They also provide valuable educational material.
Korrespondierender Autor: Trevor Thompson (1), Marjorie Weiss (2), (1) Primary Care, University of Bristol, (2) Department of Pharmacy and Pharmacology, University of Bath, Division of Primary Health Care, University of Bristol, Cotham House, Cotham Hill, Bristol BS6 6JL, UK
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