Microsoft word - newsletter issue 3 finalv2.doc

Ne wsletter
“To facilitate & disseminate high quality homeopathy research.” Welcome to the third newsletter of the Homeopathy Research Institute, a newsletter for
everyone who wants to understand and support scientific research into homeopathy.
Homeopathy for women with menopausal symptoms:
a review of the evidence
Introduction
All patients sought homeopathic treatment for one Many women consult homeopaths for problems or more of the following menopausal symptoms: hot associated with the menopause e.g. hot flushes, flushes, vaginal dryness, mood disturbance, night sweats, fatigue, anxiety, depression, mood fatigue. Many women receiving treatment for breast swings, lack of confidence, vaginal dryness, and cancer suffer from menopausal symptoms such as joint pain. A recent audit of patients receiving hot flushes. One study reports the results of 45 treatment from medically qualified homeopaths at patients who have had a diagnosis of breast cancer five NHS homeopathic hospitals reported that the 35 of whom were suffering from hot flushes menopause was the third most common reason for (Thompson & Reilly, 2003). Clover & Ratsey, patients to be referred for treatment (Thompson et describe the outcomes of 31 patients with hot al., 2008) and a study of professional homeopaths flushes, the majority of whom have had a diagnosis reported that 12.3 % of patients requested of past or current breast cancer (20/31) and who treatment for female complaints (Relton et al., also reported taking a wide range of medication 2006). This edition of the HRI newsletter (tamoxifen, HRT, antidepressants, clonidine, and summarises the chemotherapy). These two studies used patient effectiveness of homeopathy in the treatment of self-assessment menopausal symptoms. Two main types of Clinically significant improvements were reported evidence are reported, evidence from observational by Clover & Ratsey for hot flush frequency and studies and case studies of treatment by severity. while Thompson & Reilly reported homeopaths, and the more complex ‘experimental’ clinically significant improvements in effect of evidence from randomised controlled trials (RCTs) symptoms on daily living, mood, and quality of life. of ‘homeopathy’. Finally, an audit of 102 women attending an NHS significant improvements in headaches, vasomotor Observational evidence of treatment by symptoms, emotional and psychological symptoms,
homeopaths
tiredness and fatigue (Relton & Weatherley-Jones, There is a significant amount of published
observational evidence which reports the results of
patients suffering from menopausal symptoms Randomised
controlled
by homeopaths using individualised homeopathic remedies
(classical) homeopathy. Individualised homeopathy
consists of a series of in depth interviews with a There have been four RCTs of homeopathic
strong focus on the patient’s subjective experience remedies conducted. Two small (i.e. 5 patients in
to match the homeopathic medicine to the totality of total) randomised studies evaluated the use of
symptoms (including any psychological symptoms) homeopathy for menopausal symptoms in the
that emerge during a consultation and is regarded climacteric (Bekkering, 1993; Gautier, 1983) but
as the gold standard of homeopathic care.
neither study was large enough to make the Two observational studies report the outcomes of detection of a statistically significant difference patients homeopathic hospitals (Clover & Ratsey, 2002; Two full sized double blind placebo-controlled trials
Thompson & Reilly, 2003) and an audit (Relton & were conducted in hospital settings, one in the UK
Weatherley-Jones, 2005) reports the outcomes of (Thompson et al, 2005) and the other in the USA
patients in V
05). eoinst.org
The duration of the intervention varied between 16 References
weeks (Thompson et al., 2005) and 6 – 12 months
(Jacobs et al., 2005). The patient sample sizes Bekkering GM van den Bosch. (1993) Bedriegt Schone
were 83 (Jacobs et al., 2005) and 53 (Thompson et Schijn? Een Onderzoek Om De Gerapporteerde Werking
Van Een Homeopathisch Middel Te Objectiveren. Huisarts al., 2005). Both RCTs used repeated consultations en Wetenschap 36, 414-415. with a homeopath with either an individualised homeopathic remedy or placebo, however, Jacobs Clover, A., Ratsey, D., (2002), ‘Homeopathic treatment of et al., (2005) had an additional treatment arm of a hot flushes: a pilot study’, Homeopathy 91, 75-79. formulaic complex homeopathic remedy. Inclusion criteria for both trials were: three or more hot Gautier J. (1983), Essai Therapeutique Comparitif De L'action De La Clonidine et Du Lachesis Mutans Dans Le flushes a day and a history of breast cancer. Traitement des Bouffes et De Lia Chaleur De La The patient mean age was 52 (Thompson et al., Menopause. 2005) and 55 (Jacobs et al., 2005) and use of Tamoxifen was high (80% Thompson et al., 60% Jacobs, J., Herman P., Herron, K. et al. (2005), Jacobs et al.). Jacobs et al. reported a high dropout ‘Homeopathy for menopausal symptoms in breast cancer rate (28/83) perhaps due to the greater length and survivors: a preliminary randomized controlled trial’, Journal of Alternative & Complementary Medicine, 11, 1, 21-27. older age group. There was evidence that women taking the formulaic complex homeopathic remedy, Relton, C., Chatfield, K., Partington, H., et al. (2007), of ‘Patients treated by homeopaths registered with the Society Lachesis, of Homeopaths: a pilot study’. Homeopathy, 96, 87-89. experienced side effects with the development of new or proving symptoms including a significant Relton, C., Weatherley-Jones, E. (2005), ‘Homeopathy increase in headaches. service in a NHS community menopause clinic: audit of clinical Neither RCT found a statistically significant outcomes’, Journal of the British Menopause society, 11, 2, improvement in the primary outcome measures for 72-3. ‘homeopathy’ over placebo. The study by Jacobs in 2005 did however show a positive trend for Thompson, E.A., Reilly, D., (2002), ‘The homeopathic homeopathy in the reduction of hot flashes during approach to symptom control in the cancer patient: a the first three months (p=0.1) and a reduction in the prospective observational study’. Palliative Medicine 16, 3, Kupperman Menopausal Index (p=0.1) at one year. It is impossible to conclude whether these negative Thompson, E.A., Reilly, D. (2003), ‘The homeopathic results are due to insufficient sample sizes, faulty approach to the treatment of symptoms of oestrogen trial designs or the ineffectiveness of the withdrawal in breast cancer patients: A prospective interventions. observational study’ Homeopathy, 92,131-134. Thompson, E.A., Montgomery, A., Douglas, D., Reilly, D. (2005), ‘A pilot randomised double blind placebo-controlled Conclusions
trial of individualised homeopathy for symptoms of oestrogen withdrawal in breast cancer survivors’. Journal of None of the randomised controlled trials (RCTs) Alternative & Complementary Medicine, 11,1,: 13-20 performed to date have reported a statistically significant effect for the use of homeopathic Thompson, E.A., Mathie, R.T., Baitson, E.S., et al. (2008), remedies in the treatment of menopausal ‘Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals’ Homeopathy, 97,114-121. symptoms. On the other hand, the observational evidence for the effectiveness of the treatment by a homeopath is overwhelmingly positive. In this Author: C. Relton instance, we must remember that the lack of evidence of effect reported by RCTs does not constitute evidence that there is no effect. Further well conducted trials of sufficient size are required to evaluate the clinical and cost effectiveness of treatment by a homeopath. The HRI needs your support
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Source: http://homeopathe.ca/fr/documents/Homeopathy_menopausal_symptoms_a_review_of_evidence-1.pdf