The use of complementary and alternative medicine by patients attending a general otolaryngology clinic: can we afford to ignore it?

BACKGROUND: There is growing interest in use of complementary and alternative medicine (CAM) among the general population. Little information is available, however, on CAM use in adults attending an otolaryngology outpatient clinic in the UK. OBJECTIVE: The purpose of this article is to study the prevalence and pattern of CAM use among adult patients attending the ear, nose, and throat (ENT) clinic in a UK teaching hospital. STUDY DESIGN: A cross-sectional study was used. SUBJECTS AND METHODS: All patients on their primary visit to an ENT clinic were asked to complete an anonymous questionnaire for a 14-week period from October 2005 to January 2006. RESULTS: Based on 1366 completed questionnaires, 53% (728/1366) were female and 47% (638/1366) were male. Twenty-nine percent (395/1366) were older than 60 years, and 56% (763/1366) were married. Twenty percent (275/1366) had a university education. Sixty-one percent (833/1366) had used CAM, almost 36% in the preceding 12 months. The popular remedies were cod liver oil (368/833), garlic (197/833), cranberry (181/833), aloe vera (176/833), primrose oil (174/833), and Echinacea (163/833). Nonherbal therapies included massage (230/833), acupuncture (186/833), aromatherapy (135/833), chiropractic (121/833), reflexology (119/833), and homeopathy (110/833). Seventeen percent (143/833) used CAM for their current illness. Only 8% (64/833) found CAM ineffective; yet, 57% (473/833) would recommend CAM to others. Fifty-one percent (421/833) failed to inform their primary physician of their CAM use. CONCLUSION: Despite concerns over CAM efficacy, safety, and cost effectiveness, use of CAM is popular among patients attending an ENT clinic. Their use is not generally related to their presenting illness. Otolaryngologists should be aware of current trends in CAM use when managing patients, including possible interactions with other medication.

Use of complementary and alternative medicine in pediatric otolaryngology patients attending a tertiary hospital in the UK.

OBJECTIVE: Little data is available on complementary and alternative medicine (CAM) use in children attending otolaryngology services. We investigated the prevalence and pattern of CAM use among children attending the pediatric otolaryngology department in a tertiary pediatric teaching hospital in Scotland. DESIGN: A cross-sectional survey conducted by administering an anonymous questionnaire to the parents accompanying patients attending the pediatric otolaryngology department. Elective admissions and clinic attendees were included over a 3-month period in 2005/2006. SETTING: Academic tertiary care referral centre in North-East Scotland. PATIENTS: Five hundred and fifty-four consecutive patients aged less than 16 years were eligible. The response rate was 59% (n=327). MAIN OUTCOME MEASURES: Prevalence of CAM use in children. Secondary measures include types of CAM used, indications for use and communication with family physicians. RESULTS: Based on 327 responses, 93 patients (29%) had ever used CAM, 20% within the last year. Commonly used CAM preparations were cod-liver oil, echinacea, aloe vera, cranberry, primrose oil and herbal vitamin supplements. The popular non-herbal CAM included homeopathy, massage, aromatherapy, chiropractic, yoga and reiki. Nineteen percent used CAM for their admission illness. Sixty-one percent of parents thought that CAM was effective and 65% would recommend it to others. Fifty-one percent of parents stated that the family physician was unaware of CAM use by the child. CONCLUSIONS: Despite concerns regarding the efficacy, safety and cost effectiveness of complementary and alternative medicine, its use among the pediatric otolaryngology population is more common than many providers may realize. This has implications for all healthcare workers involved in their care.

[Homeopathy as seen by a nonhomeopathic otorhinolaryngologist]. / L'homéopathie vue par un ORL non homéopathe.

After 50 years of medical practice, I have widened my horizon and am interested in any method that can relieve a patient's suffering. Be it an official or a parallel therapy. If Homeopathy is more and more successful it is because of the many failures in official medicine (Allopathy), especially regarding chronic diseases. Certain patients who are intoxicated by all sorts of drugs, consult the homeopath in search of cure. The homeopath believes that the general symptoms incriminated by experimental intoxication are the same as those manifested by the sick person, and they therefore prescribe the same medecine to obtain the cure. It is the methode of "similars". For example when a patient who has not been intoxicated by Belladonna presents the same symptoms of intoxication, Belladonna is prescribed by the homeopath. What is to be thought of Homeopathy? If we have not studied and experimented it sufficiently, it is illogical to criticise it. Prejudice is the practitioner's greatest enemy. To study Homeopathy is extremely arduous and requires daily study, because for Homeopathy even more than any other medical method: "One must study every day, because one forgets every day".

[Alternative treatment methods in ENT]. / Alternative Behandlungsverfahren in der HNO-Heilkunde.

In this review, the most important complementary und alternative therapies are discussed, focusing particularly on their use in otorhinolaryngology. These therapies include balneology, Kneipp therapy, microbiological therapy, fasting, excretion therapy, different oxygen therapies, hydro-colon therapy, urine therapy, own-blood therapy, Bach therapy, orthomolecular therapy, order therapy, environmental medicine, phytotherapy, homeopathy, complex homeopathy, anthroposophy, neural therapy, electroaccupuncture according to Voll and similar therapies, nasal reflex therapy, reflex-zone massage, manual therapy, massage, lymph drainage, aroma therapy, thermotherapy, bioresonance, kinesiology, hopi candles, and dietetics. Some of these methods and regimens can be recommended, but others should be rejected. In universities, these methods are only represented to a minor extend, but are more accepted by otorhinolaryngologists in practice. This paper provides a guide to which alternative therapies are sensible and possible in otorhinolaryngology. The aim is to stimulate interest in these methods. It is necessary to discuss these alternative methods reasonably and credibly with patients.

Study of the practice of homeopathic general practitioners in France.

Little is known about the practice of homeopathic general practitioners (GPs) in France. We report a descriptive, cross-sectional study on this subject. The aim was to acquire a clearer idea of (1) the type of patients who consult homeopathic GPs and (2) the type of treatment provided by such GPs, in terms of diagnoses, prescriptions and costs. The survey was carried out on a representative sample of the French homeopathic GP population and covered three seasons of the year. The data was collected by means of a questionnaire which GPs completed for each consulting patient. It emerged that the type of patients who consult homeopathic GPs are chiefly women, between the ages of 20 and 54, living in an urban environment, not in employment, covered by National Health Insurance for Salaried Workers, and belonging to a Mutual Benefit Association. The most common reasons for consultation were ENT disorders, stress and anxiety. The homeopathic GPs mainly used homeopathy to treat these disorders. On average, four medicinal products per patient were prescribed per 2-month course of treatment, for an average reimbursed cost of 3.78 Euros.

Medicamentos de rinofaringitis, amigdalitis y otitis agudas / Rhinitis, tonsillitis and acute otitis drugs

Tradicionalmente y en virtud de las reglas de la Nosologia Clasica, la rinofaringitis, amigdalitis y otitis agudas se estudian por separado, pero la clinica nos ensena que son manifestaciones ligadas entre si, pudiendo encontrar un conjunto de sintomas caracteristicos que nos van a permitir definir un terreno particular. Todas las afecciones de rinofaringe, en primer lugar, se caracterizan por inflamaciones congestivas que mas tarde pasan a supurativas, estando localizadas en el tejido linfatico situado en la rinofaringe. Por ellas mismas no son afecciones peligrosas, aunque la practica diaria nos permite ver que son recidivantes debiendo tambien tomar en cuenta el factor horas-nino perdidas en la escuela, y las repercusiones familiares que esto trae aparejado. En la primera fase, los sintomas generales dominan el cuadro; es la fase de congestion y tres medicamentos son los caracteristicos: Aconitum napellus, Belladona atropa, Ferrum phosphoricum