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Evidence

There is a growing body of clinical evidence to show that Homeopathy has a positive effect.

The following information has been published on the British Homeopathic Association & The Faculty of Homeopathy websites respectively.  This information includes the types of scientific studies which have been carried out on Homeopathy, the outcomes of these studies, and the difficulties involved in scientifically testing homeopathic treatment.

Randomised Controlled Trials (RCT's)

The widely accepted method of proving whether or not a medical intervention works is called a randomised controlled trial (RCT). One group of patients, the control group, receive placebo (a dummy pill) or standard treatment, and another group of patients receive the medicine being tested. The trial becomes double-blinded when neither the patient nor the practitioner knows which treatment the patient is getting. RCTs are often referred to as the “gold standard” of clinical research.

A total of 164 RCT papers in homeopathy (on 89 different medical conditions) have been published in good quality scientific journals. 43% of the RCTs have a balance of positive evidence, 6% have a balance of negative evidence, and 49% have not been conclusively positive or negative; 2% of the RCTs do not contain data that are suitable for analysis. For full details of all these RCTs and more in-depth information on the research in general, visit the research section of the Faculty of Homeopathy’s website. Also, see 2-page summary of evidence with full references within the British Homeopathic Association Website.

The above figures are strikingly similar to data obtained from an analysis of 1016 systematic reviews of RCTs (and therefore of many more than that number of RCTs) in conventional medicine: 44% of the reviews concluded that the interventions studied were likely to be beneficial (positive); 7% concluded that the interventions were likely to be harmful (negative); and 49% reported that the evidence did not support either benefit or harm (non-conclusive). [El Dib RP, Atallah AN, Andriolo RB (2007). Mapping the Cochrane evidence for decision making in health care. Journal of Evaluation in Clinical Practice; 13:689–692.]

Systematic Reviews

The most solid evidence for a treatment comes from critically assessing more than one RCT in a carefully defined way. This is known as a systematic review. Four out of five major systematic reviews of RCTs in homeopathy have concluded (with certain caveats) that homeopathy has an effect greater than placebo. Systematic reviews of RCTs in specific medical areas have presented positive conclusions for homeopathy in seven: childhood diarrhoea, hay fever, influenza treatment, post-operative ileus, respiratory tract infection, rheumatic diseases and vertigo (see Faculty of Homeopathy website for details).

For full details of all 164 RCT papers and more in-depth information on the research, visit the research section of the Faculty of Homeopathy’s website. This includes details of those RCTs that were either negative or non-conclusive. The British Homeopathic Association's own systematic review programme will provide further insight into these research findings.

Difficulties with RCT's

The RCT model of measuring efficacy of a drug poses some challenges for homeopathic research. In homeopathy, treatment is usually tailored to the individual. A homeopathic prescription is based not only on the symptoms of disease in the patient but also on a host of other factors that are particular to that patient, including lifestyle, emotional health, personality, eating habits and medical history. The “efficacy” of an individualised homeopathic intervention is thus a complex blend of the prescribed medicine together with the other facets of the in-depth consultation and integrated health advice provided by the practitioner; under these circumstances, the specific effect of the homeopathic medicine itself may be difficult to quantify with precision in RCTs.

An alternative research approach, which the majority of researchers have adopted, is the “one drug fit all patients” type of RCT. Such trials are capable of quantifying efficacy of the homeopathic “drug” under investigation, but they may yield results that are of questionable relevance to the practice of homeopathy in the “real world”.

Non-randomised Studies

There are other types of study that form part of the evidence base for any medical intervention. Clinical outcome studies record the patient’s self-reported response after treatment. Studies of this kind are neither randomised nor controlled. Although they lie near the lower end of the “hierarchy” of research evidence, study designs such as these can reflect how homeopathy is working in practice and indicate where RCT research might be targeted.

The experience of patients

Many patients referred for homeopathic treatment have a complexity of health problems. They may suffer from more than one disease. They could be young children or elderly people. They may be pregnant. None of these sorts of patients would be accepted for a drug trial in conventional medicine, so their reactions to treatment are not reflected in the results of RCTs. The recording of clinical data from everyday practice reflects the experiences of real patients and is becoming an increasingly valued part of evidence-based medicine. View results from the homeopathic hospitals.

There are 21 non-randomised studies that have focused on a particular medical condition or set of conditions. References to these studies are listed below:

Ammerschlager H, Klein P, Weiser M, Oberbaum M (2005). Behandlung von Entzündungen im Bereich der oberen Atemwege – Vergleich eines homöopathischen Komplexpräparates mit Xylometazolin [Treatment of inflammatory diseases of the upper respiratory tract – comparison of a homeopathic complex remedy with xylometazoline]. Forschende Komplementärmedizin und Klassische Naturheilkunde; 12: 24–31.

Derasse M, Klein P, Weiser M (2005). The effects of a complex homeopathic medicine compared with acetaminophen in the symptomatic treatment of acute febrile infections in children: an observational study. Explore (NY); 1: 33–39.

Friese K-H, Kruse S, Lüdtke R, Moeller H (1997). The homoeopathic treatment of otitis media in children – comparisons with conventional therapy. International Journal of Clinical Pharmacology and Therapeutics; 35: 296–301.

Goossens M, Laekeman G, Aertgeerts B, Buntinx F (2009). Evaluation of the quality of life after individualized homeopathic treatment for seasonal allergic rhinitis. A prospective, open, non-comparative study. Homeopathy; 98: 11–16.

Haidvogl M, Riley DS, Heger M, et al (2007). Homeopathic and conventional treatment for acute respiratory and ear complaints: a comparative study on outcome in the primary care setting. BMC Complementary and Alternative Medicine; 7: 7.

Hubner R, van Haselen R, Klein P (2009). Effectiveness of the homeopathic preparation Neurexan compared with that of commonly used valerian-based preparations for the treatment of nervousness/restlessness – an observational study. Scientific World Journal; 9: 733–745.

Klopp R, Niemer W, Weiser M (2005). Microcirculatory effects of a homeopathic preparation in patients with mild vertigo: an intravital microscopic study. Microvascular Research; 69: 10–16.

Müller-Krampe B, Oberbaum M, Dipl-Math PK, Weiser M (2007). Effects of Spascupreel versus hyoscine butylbromide for gastrointestinal cramps in children. Pediatrics International; 49: 328–334.

Rabe A, Weiser M, Klein P (2004). Effectiveness and tolerability of a homoeopathic remedy compared with conventional therapy for mild viral infections. International Journal of Clinical Practice; 58: 827–832.

Schmiedel V, Klein P (2006). A complex homeopathic preparation for the symptomatic treatment of upper respiratory infections associated with the common cold: An observational study. Explore (NY); 2: 109–114.

Schneider C, Klein P, Stolt P, Oberbaum M (2005). A homeopathic ointment preparation compared with 1% diclofenac gel for acute symptomatic treatment of tendinopathy. Explore (NY); 1: 446–452.

Schneider C, Schneider B, Hanisch J, van Haselen R (2008). The role of a homoeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complementary Therapies in Medicine; 16: 22–27.

Schröder D, Weiser M, Klein P (2003). Efficacy of a homeopathic Crataegus preparation compared with usual therapy for mild (NYHA II) cardiac insufficiency: results of an observational cohort study. European Journal of Heart Failure; 5: 319–326.

Walach H, Lowes T, Mussbach D, et al (2001). The long term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis. British Homeopathic Journal; 90: 63–72.

Waldschütz R, Klein P (2009). The homeopathic preparation Neurexan vs. valerian for the treatment of insomnia: an observational study. Scientific World Journal; 8: 411–420.

Witt CM, Lüdtke R, Baur R, Willich SN (2009). Homeopathic treatment of patients with chronic low back pain: a prospective observational study with 2 years’ follow-up. Clinical Journal of Pain; 25: 334–339.

Witt CM, Lüdtke R, Willich SN (2009). Homeopathic treatment of chronic headache (ICD-9: 784.0) – a prospective observational study with 2-year follow-up. Forschende Komplementärmedizin; 16: 227–235.

Witt CM, Lüdtke R, Willich SN (2009). Homeopathic treatment of patients with chronic sinusitis: a prospective observational study with 8 years follow-up. BMC Ear Nose and Throat Disorders; 9: 7.

Witt CM, Lüdtke R, Willich SN (2009). Homeopathic treatment of patients with dysmenorrhea: a prospective observational study with 2 years follow-up. Archives of Gynecology and Obstetrics; 280: 603–611.

Witt CM, Lüdtke R, Willich SN (2010). Homeopathic treatment of patients with migraine: a prospective observational study with a 2-year follow-up period. Journal of Alternative and Complementary Medicine; 16: 347–355.

Witt CM, Lüdtke R, Willich SN (2009). Homeopathic treatment of patients with psoriasis – a prospective observational study with 2 years follow-up. Journal of the European Acadamy of Dermatology and Venereology; 23: 538–543.

Medical Conditions with overall positive evidence for Homeopathy

Listed below are 50 medical conditions in which there is currently a positive balance of evidence for homeopathy in randomised controlled trials (RCTs).

References are listed, however, for complete details of these research studies in homeopathy, visit the research section of the Faculty of Homeopathy website, which also identifies groups of RCTs that were non-conclusive or negative.

Clearly positive direction of RCT evidence in 3 conditions:

Fibromyalgia 1–6

Influenza 7–9

Seasonal allergic rhinitis 10–18

Tentatively positive direction of RCT evidence in 47 conditions:

Allergic asthma 19, 20

Arsenic toxicity 21–24

Attention-deficit hyperactivity disorder (ADHD) 25, 26

Blood coagulation 27, 28

Childhood diarrhoea 29–32

Common cold 33, 34

Depression 35, 36

Female infertility 37–39

Insomnia 40–42

Irritable bowel syndrome (IBS) 43, 44

Low back pain 45–47

Muscle soreness 48–55

Osteoarthritis 56–58

Otitis media (acute) 59, 60

Post-operative bruising 61, 62

Post-operative pain 63–67

Sinusitis 68–72

Upper respiratory tract infection (URTI) 73–76

Vertigo 77, 78

Non-replicated research: singleton RCTs:

Aphthous ulcer 79

Brain injury 80

Bronchitis 81

Chronic fatigue syndrome 82

Immune function 83

Nocturnal enuresis 84

Non-allergic rhinitis 85

Oral lichen planus 86

Perennial allergic rhinitis 87

Plantar fasciitis 88

Post-operative oedema 89

Post-operative wound healing 90

Postpartum bleeding 91

Postpartum lactation 92

Premenstrual syndrome (PMS) 93

Psoriasis 94

Radiodermatitis 95

Renal failure 96

Respiratory insufficiency 97

Seborrhoeic dermatitis 98

Sepsis 99

Snoring 100

Stomatitis 101

Tonsillitis 102

Tracheal secretions 103

Uraemic pruritus 104

Varicose veins 105

Xerostomia (Dry mouth) 106

Pilot Study of 5 Homeopathic Hospitals

In a pilot study published in 2008, data from 1602 follow-up patient appointments at all five NHS homeopathic hospitals were collected together over a one month period.

Eczema, chronic fatigue syndrome, menopausal disorder, osteoarthritis and depression were the ‘top five’ most referred conditions. The medical problems referred to the hospitals typically are chronic conditions where available conventional treatments are often not effective. In total, the study identified 235 separate medical complaints treated at the hospitals during one month.

At just their second homeopathic appointment, 34% of follow-up patients overall reported an improvement that affected their daily living. For patients at their sixth appointment, the corresponding improvement rate was 59%. The study showed that reported health benefit may be gained more quickly in some medical conditions than in others. Read full paper.

The pilot findings are informing a programme of standard setting for treatment outcomes in the NHS homeopathic hospitals.

Bristol Homeopathic Hospital Outpatient Study

One of the most comprehensive patient outcome surveys was an analysis of over 23,000 outpatient consultations at the Bristol Homeopathic Hospital from November 1997 to October 2003. This represented over 6,500 individual patients whose outcome was recorded at follow-up. More than 70% of these follow-up patients recorded clinical improvement following homeopathic treatment.

Many of the patients in the analysis had previously received mainstream medical intervention at the secondary care level and had either failed to respond satisfactorily or had been unable to tolerate the medication prescribed.

Homeopathy therefore may achieve positive clinical outcomes in certain conditions that have not yet been proven in RCTs, such as Crohn’s disease, depression, eczema, headache, and menopausal syndrome. Full details are given in the original article.


Clinical Condition
 
% follow-up patients showing clinical improvement
Asthma (under 16s) 89%
Chronic fatigue syndrome 72%
Crohn’s disease/ulcerative colitis 76%
Depression  71%
Eczema (under 16s) 82%
Headache/migraine 74%
 Irritable bowel syndrome 71%
 Menopausal syndrome 77%
Rheumatoid arthritis  70%

Royal London Homeopathic Hospital Survey

The 500-patient survey at the Royal London Homeopathic Hospital showed that many patients were able to reduce or stop conventional medication following homeopathic treatment.(9)

The size of the effect varied between diagnoses: for skin complaints, for example, 72% of patients reported being able to stop or reduce their conventional medication; for cancer patients there was no reduction.

Reference(9):

Sharples F, van Haselen R, Fisher P. NHS patients’ perspective on complementary medicine. Complementary Therapies in Medicine, 2003; 11: 243–248.

Evidence of Safety of Homeopathic Medicines

A review of the safety of homeopathy, conducted by doctors associated with the Royal London Homoeopathic Hospital (RLHH) studied papers published between 1970 and 1995 for reports of adverse effects of homeopathy.

Adverse effects reported in clinical trials were temporary aggravations of symptoms or other mild and transient effects (mostly headaches, tiredness, skin eruptions, dizziness or diarrhoea).

Only a very few isolated reports of proper adverse effects were attributable to homeopathic medicines.(1) The authors of the review concluded: “Homeopathic medicines in high dilutions, prescribed by trained professionals, are probably safe and unlikely to provoke serious adverse reactions”.

One of the expressed reasons for the popularity of homeopathy among patients at the RLHH is that it does not have the side effects associated with many conventional drugs.(2)

References:

1. Dantas F, Rampes H. Do homeopathic medicines provoke adverse effects? A systematic review. British Homeopathic Journal 2000; 89: S35–8.

2. Sharples F, van Haselen R. Patients’ perspectives on using a complementary medicine approach to their health. A survey at the Royal London Homoeopathic Hospital NHS Trust. London, 1998.

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