Diagnoses and treatment in homeopathic medical practice

Background: Despite increasing interest in complementary medicine worldwide, there has been no systematic large-scale documentation of medical homeopathic care. Objective: We therefore conducted a prospective cohort study aimed at characterizing patients seeking homeopathic care and their treatment. Patients and Methods: From September 1997 to June 1999, patients of all age groups who were visiting a homeopathic care center for the first time were included consecutively in the study and followed up for 24 months. Diagnostic procedures and prescriptions were documented using specific case report forms. Main Outcome Measures: Diagnoses (ICD-9), medical history, consultations, and prescriptions. Results: A total of 3,981 patients were included in the study, 2,851 adults (29% men, mean age 42.5 +/- 13.1 years; 71% women, 39.9 +/- 12.4 years) and 1,130 children (52% boys, 6.5 +/- 3.9 years; 48% girls, 7.0 +/- 4.3 years). Almost all patients suffered from chronic conditions for 10.3 +/- 9.8 (adults) and 4.3 +/- 3.7 years (children). The most frequent diagnoses were allergic rhinitis in adult males, headache in adult females, and atopic dermatitis in children (both genders). The typical homeopathic initial consultations took 117 +/- 43 minutes for adults and 86 +/- 36 minutes for children, not varying much between primary diagnoses. In the observed 2 years the patients had on average 8.6 +/- 9.3 (adults) and 8.9 +/- 9.6 (children) consultations, approximately 50% each by telephone and face-to-face. Physicians most often prescribed the classical 'great' remedies (like sepia, sulfur, natrium mur., lycopodium), but in total, nearly 600 different homeopathic remedies were used. Conclusions: Our study provides a wealth of data on the medical practice of classical homeopathy. In terms of treatment, polychrests are used frequently, although it should be noted that a large proportion of patients received 'small remedies' instead. Most patients are treated for chronic diseases. The present results will, in concert with follow-up outcome analysis, aid in determining the effectiveness of medical homeopathic practice.