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Systematic review of clinical trials supports homeopathy in fibromyalgia and chronic fatigue syndrome
RCTs were included if they met 7 criteria and were assessed for possible bias using the Scottish Intercollegiate Guidelines Network (SIGN) 50 guidelines. Identified studies were grouped into anxiety or stress, sleep or circadian rhythm complaints, premenstrual problems, attention-deficit/hyperactivity disorder, mild traumatic brian injury, and functional somatic syndromes. Twenty-five eligible studies were identified; study quality according to SIGN 50 criteria varied, with 6 assessed as good with respect to minimizing bias, 9 as fair, and 10 as poor. Outcome was unrelated to SIGN quality.
In the category of functional somatic syndromes 5 of the 6 studies provided some evidence for efficacy in either fibromyalgia or chronic fatigue syndrome. The low placebo response (4%–15%) and modestly consistent rates of response to homeopathy (26%–50%) in these disorders and the larger sample size of over 200 patients may have yielded more precise estimates than in the other categories. Findings for other conditions were mixed and inconclusive. There was no evidence of publication bias.
Davidson JR et al (2011) Homeopathic treatments in psychiatry: a systematic review of randomized placebo-controlled studies. Journal of Clinical Psychiatry, 72:795-805 [PubMed]
In general, results were significant for the drug usage indicator: the population of homeopathic care users uses fewer drugs than the standard population. Furthermore, it can be seen that the number of drugs and the drugs expenditure reduce significantly after homeopathic treatment. Hospitalization indicators tended to favour patients who had received homeopathic treatment but were not always statistically significant.
This paper demonstrates a new methodological approach to assess the effectiveness of a therapeutic modality, without ad-hoc clinical trials. The assessment of effectiveness is crucial for public health institutions that integrate non-conventional medicines into the public health care system: this methodological approach implies a reduction in timing and costs and, moreover, it permits to monitor more patients. The results suggest that use of homeopathy is associated with lower use of prescribed medication.
The need for research into health promotion and CAM (Complementary and Alternative Medicine) was the title of the third meeting of the MEP CAM Interest Group of the European Parliament held on October 11th, 2011 in the Parliament. The meeting was chaired by MEP Sirpa Pietikäinen, PEP Fin. The meeting participants first listened to a presentation entitled ‘CAM and the Research Framework Programmes’ given by Mr. Ole Olesen, Senior Scientific Officer, Infectious Diseases & Public Health unit, DG Research and Innovation. This was followed by a presentation on The Contribution of Complementary Medicine to European Public Health – Towards a Research Agenda by Prof Dr Harald Walach, of the European University Viadrina Frankfurt/Oder, Germany.
After a brief introduction to DG Research and the structure and content of the health theme in the current EU FP7 research framework programme, Mr Olesen referred to two current research projects in CAM (CAMbrella and TCM) funded under FP7 that take up most of 5.5 million euros currently invested in CAM research. He then presented the change in thinking within DG Research that will underpin the new research framework programme FP8 or ‘Horizon 2020’, 2013-2020. The switch is to a broader common strategic framework that includes common strategies with a focus on ‘societal challenges’. Among the societal challenges identified is ‘Health, demographic change and wellbeing’ - how to provide better health while maintaining an economically sustainable healthcare system. Under this challenge three main areas of activity were outlined, prevention, treatment and healthcare sustainability, all of which CAM has the potential to contribute to. In conclusion he stated that he thought Horizon 2020 may aim at a broader, more holistic approach to health, including additional focus on well-being. but that, as always, research activities selected for funding are selected on competitive basis of scientific excellence, impact and implementation.
In describing the added value of CAM as a patient oriented multi therapeutic approach to treatment and health, Prof. Walach outlined the advantages of CAM as well as the problems and obstacles which confront CAM in receiving sufficient support for much needed research. Mainstream orientation and predominance in classical pharmacological research as well as very little industry support and marginal support, mostly from small charitable sources, prohibit adequate large scale research in CAM in Europe. International comparisons reveal that WHO has declared CAM and traditional medicines important elements in healthcare worldwide and also demonstrate that considerable funds are dedicated to CAM research in other countries (e.g. USA $128 million for 2011). As a way forward, Prof. Walach strongly recommended the provision for funding for CAM research be included in the health research strategic framework of Horizon 2020. He argued in favour of a ring-fenced approach focusing on model validity and European consortia, asked for specific and knowledgeable reviewers to be included in evaluation panels and recommended as a strategy following the recommendations of the roadmap that will be outlined by the CAMbrella project towards the end of 2012.
In the ensuing discussion on the objectives of Horizon 2020, the potentially new and open as well as holistic approach of the programme was underlined. In principle it would seem to offer CAM much better research opportunities than before. It was agreed that CAM has to be seen as an important ‘innovation factor’ in Horizon 2020. However, the selection criteria for projects, the traditional orientation of conventional reviewers and the role of the Programme Committee (national governments) in setting the priorities for the Framework - and for the Annual Work - Programmes are still existing barriers for CAM research at EU level. Members of the CAM Interest Group agreed that the European Parliament has an important role to play in introducing and safeguarding the opportunities for CAM research in the new research programme during its forthcoming discussion in Parliament and that these issues must be taken up accordingly.
Presentations and background document can be found here.
The newsletter highlights EUROCAM, the alliance of patients, doctors and practitioners in the field of CAM, which is committed to raising public awareness of the public-health benefits of CAM, especially in terms of prevention and health promotion, patient safety, patient-centred health services, mental health, palliative care, health economics and healthy ageing.
Responding to increasing use of CAM by the European public, the European Commission's Directorate-General for Research has funded CAMbrella, a project to develop a roadmap for future European research in CAM that is appropriate for Europe's health care needs.
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This investigation is particularly interesting because, even though several clinical studies have demonstrated an effect of highly diluted homeopathic medicines, until now their action had not been directly observable.
In the Indian research study the effect of different homeopathic potencies of Aconitum napellus, Arsenicum album, Gelsemium sempervirens, Phosphorus, Pulsatilla nigricans, and Sulphur on heart rate variability and blood flow variability were recorded in 77 subjects within an age range of 18-35. The results show a range of responses that are varied and interesting e.g. a pattern seems to emerge from these experiments that medium potencies such as 30c and 200c have probable action on heart rate variability and higher potencies such as 1M have probable action on blood flow variability. However, the authors state this is an exploratory study and that ‘These are observations from exploratory experiments in emerging areas of physiologic variability and need validation by repeated experiments of this type. Detection of response was the primary objective of this study, which has been achieved. The number of subjects in each group was small; hence it was not possible to show the statistical significance of the results, an aspect that will be covered in future studies.’
With the use of the medical analyzer, the researchers may have found a way to move research in the area of ultramolecular homeopathic preparations forward. Their research study suggests that it is possible to record the response of homeopathic medicines on physiologic parameters of the autonomic nervous system, thus offering a means of measuring a direct physiologic effect in an objective, rather than subjective, manner.
Mishra N, Muraleedharan KC, Paranjpe AS, Munta DK, Singh H, Nayak C (2011) An Exploratory Study on Scientific Investigations in Homeopathy Using Medical Analyzer. Journal of Alternative and Complementary Medicine, 17:705-710.