Do sociodemographic characteristics associated with the use of CAM differ by chronic disease?

BACKGROUND: Complementary and alternative medicine (CAM) is oftenused to alleviate the discomfort, disability and pain involved in many chronic diseases. Besides this, females, middle-aged and higher educated people are also known to use CAM the most. This study explores whether the sociodemographic characteristics associated with CAM use differ by type of disease. METHODS: The following data were taken from the Belgian Health Interview Survey 2013 for the individuals aged 15+ years (n = 8942): sociodemographic characteristics, past 12-month diseases (using a list) and contact with a homeopath, chiropractor, acupuncturist and/or osteopath (CAM-therapists) in the past year. The association between CAM use and disease, controlled for gender, age, education and conventional medicine use, was assessed through logistic regressions. When interactions with the sociodemographic characteristics were found, stratified regressions were conducted. RESULTS: People with musculoskeletal diseases [odds ratio (OR) = 2.6], allergy (OR = 1.4) and severe headache (OR = 1.5) had higher odds of using CAM in the past year with statistical significance. For musculoskeletal diseases, the odds of using CAM was higher, with statistical significance, for every sociodemographic subclass. For allergy, CAM use was higher among men, people aged 45+ years and lower educated people, while for severe headache CAM use was higher among women, people aged 45+ years and higher educated people, all with statistical significance. CONCLUSIONS: Sociodemographic characteristics associated with CAM use differ by diseases. The role of CAM in disease management cannot be ignored. Making physicians aware for which disease CAM is used and by whom, may facilitate disease management.

Mastitis prevention and control practices and mastitis treatment strategies associated with the consumption of (critically important) antimicrobials on dairy herds in Flanders, Belgium.

The main objectives of this study were to evaluate to what extent variations in herd-level antimicrobial consumption (AMC) can be explained by differences in management practices that are consistently effective in the prevention of (sub)clinical mastitis, on the one hand, and by differences in mastitis treatment strategies, on the other hand. Antimicrobial consumption data were obtained during 2012 and 2013 by "garbage can audits" and expressed as antimicrobial treatment incidences (ATI) for all compounds combined (total ATI) and for the critically important antimicrobials for human health separately. Data on mastitis prevention and control practices were obtained via face-to-face interviews performed during herd visits in March 2013. Some management practices and treatment strategies related to udder health were associated with the total AMC. However, the results demonstrated that implementing effective udder health management practices does not necessarily imply a low AMC and vice versa. Herds participating in a veterinary herd health management program and herds selectively drying off cows used fewer antimicrobials compared with herds not participating in such a program or applying blanket dry-cow therapy. Moreover, herds treating (some) (sub)clinical mastitis cases with intramammary homeopathic substances consumed fewer antimicrobials than herds not applying such homeopathic treatments. Besides these factors, no other direct association was found between effective udder health management practices on the one hand and AMC on the other hand. Also, the use of critically important antimicrobials was only associated with the way in which subclinical mastitis cases were treated. The latter indicates that the AMC of critically important antimicrobials is potentially driven by factors other than those included in this study such as those related to the "mindset" of the veterinarians and their farmers. Future research should therefore aim to unravel the reasoning of vets and their farmers behind the use of those critically important antimicrobials for the treatment of mastitis and other diseases.

The use of traditional and complementary medicine among patients with multiple sclerosis in Belgium.

Introduction. Conventional treatment of multiple sclerosis (MS) is often disappointing. As a result, some of these patients seek salvation in traditional and complementary medicine (T&CM). The aim of this study is to describe how many patients with MS use T&CM and what their motives and expectations are in doing so. Methods. Ninety-nine patients with diagnosed MS, attending the service of ambulatory revalidation of the National Clinic for Multiple Sclerosis in Melsbroek (Belgium) were included in February 2004 in this retrospective study. All patients had MS resulting in motoric or psychosocial symptoms. The disability was not quantified for this study. Participants were interviewed by means of a structured questionnaire on their current treatment of MS including T&CM. Results. In total 44% of the participants had experiences with T&CM. The most frequently used T&CM were homeopathy and acupuncture. Participants using conventional treatment were more satisfied with the support (p=0.006) and the treatment outcome (0.018) than T&CM users. The use of T&CM was not related to gender, education, living conditions, causal treatment such as disease modifying-therapy (DMT), grade of disability or subtype of the disease. Conclusion. Patients diagnosed with MS seek hope in T&CM such as homeopathy or acupuncture. The results of this study suggest that MS patients need more professional support in their personal search for alternative therapies. Key point. 50% of patients diagnosed with multiple sclerosis search relief in traditional and complementary medicine such as homeopathy or acupuncture. These patients often feel compelled to try every opportunity to heal, often stimulated or urged on by friends or relatives. Multiple sclerosis patients are more satisfied with their conventional treatment than with the traditional and complementary medicine.

Survey COVID-19 first peak 2020: viewpoint of Belgian homeopathic medical doctors

This retrospective observational survey of the practice of Homeopathic Medical Doctors in Belgium including 313 patients presenting mild COVID-19 symptoms allows us to conclude that during such epidemic situation for which not any effective therapy exists and no vaccination is possible homeopathy should be considered. The efficiency score (healing of symptoms in less than 8 days) is relevant for 83,1% of these patients. 4 homeopathic medicines were prescribed to 66% of them. 1,3% needed hospitalization for some time. Not any loss of chance to cure occurred for these patients. Market data reveals that homeopathy has been largely used for prevention and healing during the early peak of COVID-19 in Belgium.

[Is homeopathy superior to placebo? Controversy apropos of a meta-analysis of controlled studies]. / L'homéopathie est-elle supérieure au placebo? Controverse a propos d'une méta-analyse des etudes contrôlées.

At a time when scientists support Evidence-Based Medicine, the Parliament of Belgium has recently decided to recognize four alternative medicines, among which homeopathy. Whereas this discipline does not rely on any scientific basis, it appears to be popular, especially in general practice. The homeopaths have recently taken arguments from a meta-analysis published in 1997 in the Lancet of 89 placebo-controlled trials. This study indeed concluded that the results are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, this meta-analysis contains several methodological flaws. Furthermore, it is recognized that results of a meta-analysis may not be confirmed in large well-performed clinical trials. Thus, homeopathy should still provide the evidence that conventional medicine has regularly brought during the last two decades in many fields of therapeutics, with the respect of the rigorous rules of "Good Clinical Practice", leading to "Evidence-Based Medicine".

Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent upper respiratory tract infections.

OBJECTIVE: To investigate the intrinsic effects of individually prescribed homoeopathic medicines. DESIGN: Randomised double blind placebo controlled study. SETTING: Paediatric outpatient department of university hospital. PATIENTS: 175 children with frequently recurring upper respiratory tract infections. Of the 170 children evaluable, 86 were randomised to homoeopathic medicines (47 boys, 39 girls; median age at start 4.2 years; median number of episodes in past year 4) and 84 to placebo (43 boys, 41 girls; median age at start 3.6 years; median number of episodes in past year 4). MAIN OUTCOME MEASURES: Mean score for daily symptoms, number of antibiotic courses, and number of adenoidectomies and tonsillectomies over one year of follow up. RESULTS: The mean daily symptom score was 2.61 in the placebo group and 2.21 in the treatment group (difference 0.41; 95% confidence interval -0.02 to 0.83). In both groups the use of antibiotics was greatly reduced compared with that in the year before entering the trial (from 73 to 33 in the treatment group and from 69 to 43 in the placebo group). The proportion of children in the treatment group having adenoidectomies was lower in the treatment group (16%, 8/50) than in the placebo group (21%, 9/42). The proportion having tonsillectomies was the same in both groups (5%). CONCLUSION: Individually prescribed homoeopathic medicines seem to add little to careful counselling of children with recurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of antibiotics, and need for adenoidectomy and tonsillectomy.

J'ai vu une femme publique'. Sexuality, venereal disease and homoeopathy in nineteenth-century Ghent: the tale of the patient.

Using the casebooks of the Ghent homoeopathic physician Gustave van den Berghe (born Zwevegem, 1836; died Ghent, 1902), this essay reconstructs patients' experience with sexuality and venereal disease during the late 19th century. Van den Berghe's records are uncharacteristic in that they do not translate the patient's descriptions into medical terms. The casebooks therefore represent an opportunity to hear about the disease and its social context in the patient's own words. Reading these case reports carefully, we can begin to understand not only what it meant to suffer from venereal disease, but also what motivated people to seek homoeopathy in general and this healer in particular.

An observational study of patients receiving homeopathic treatment.

BACKGROUND: Observational studies have recently contributed useful information to the debate about the utility of homeopathic treatment in everyday practice. AIM: To gather data about routine homeopathic general practice. SETTING: Eighty general medical practices in Belgium where physicians were members of the Unio Homoeopathica Belgica. METHODS: All patients and their physicians visiting the practices on a specified day completed a questionnaire. RESULTS: A total of 782 patients presented with diseases of all major organ systems which were of sufficient severity to interfere with daily living in 78% of cases. Compared to previous conventional treatment, patients reported that consultations were much longer but costed less. One or more conventional drug treatments were discontinued in over half (52%) of the patients: CNS (including psychotropic) drugs (21%), drugs for respiratory conditions (16%) and antibiotics (16%). Conventional drugs were prescribed to about a quarter of patients (27%), mostly antibiotics and cardiovascular medication. The antibiotics were almost exclusively (95%) used to treat respiratory infections. Prescription costs (including conventional medicines) were one-third of the general practice average. Patients' satisfaction with their homeopathic treatment was very high (95% fairly or very satisfied), and ratings of their previous treatment was much lower (20%). The great majority (89%) said that homeopathy had improved their physical condition; 8.5% said that it had made no difference, 2.4% said that homeopathy had worsened their condition. Physicians' ratings of improvement were similar. Previous conventional treatment had improved 13% of patients, made no difference to 32%, and had worsened the condition of over half (55%). A similar pattern was seen for psychological symptoms. CONCLUSIONS: Patients were very satisfied with their homeopathic treatment, both they and their physicians recorded significant improvement. Costs of homeopathic treatment were significantly lower than conventional treatment, and many previously prescribed drugs were discontinued.