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The Case for Homeopathy

H. GROWING USE OF HOMEOPATHY

i. Growth amongst patients
ii. Professional acceptance of homeopathy by doctors

Growth amongst patients
The first land-mark paper reflecting the growth in use of complementary medicine, including homeopathy, was published by an epidemiologist at Harvard university, Dr. Eisenburg, in the prestigious New England Journal of Medicine in1993 55. Dr. Eisenberg’s team found that –

• More than 1/6th of Americans visited a provider of ‘unconventional therapy’ in the year of study. The majority of the visits were for chronic problems and exceeded the number of visits to all U.S. primary care practitioners. 72% of these patients did not inform their medical doctors of these visits.

• More than 1/3rd of Americans used one ‘unconventional therapy’ in the year of study.

• 32% of these visits were to homoeopaths, with a mean of 6 visits per user in the previous year.

• $13,7 billion was spent on alternative health care in 1990, of which ¾ was not reimbursed by insurers or medical systems. This showed that the American public was prepared to pay out-of-pocket for alternative health care (i.e. non-insured benefits): homeopathy accounted for over 1/3 of the visits made.

Seven years later Eisenberg found that between 1990 and 1997 there was nearly a 50% increase in total visits to alternative practitioners and that 42% of Americans were using ‘alternative care’. Homeopathy was one of the modalities that showed the most growth 56.

The Lancet published a study in 1996 describing significant use of Complementary & Alternative Medical Therapy in Australia 57. One quarter of respondents visited at least one alternative health care provider during the period of the study and extrapolated expenditure on alternative medicines was almost double that of patient contributions towards all pharmaceutical drugs in 1992/3.

A population-based survey in England, published in Complementary Therapies in Medicine in 2001 58, showed that just under 50% of the population had used one of 6 complementary therapies, including homeopathy, in their life-time. 11% of adults in England used complementary therapies in the 12 months of the study, excluding reflexology and aromatherapy and an additional 15% self-medicated with homeopathic or herbal medicines.

A study published in the European Journal of Clinical Pharmacology in 2002 showed that 16% of the Italian population used at least one ‘unconventional therapy’ in 1997-9, of which homeopathy was the most frequently used (8.2%) 59. Yet the authors ranked Italy as one of the ‘light’ European users of ‘unconventional therapies’.

Homeopathy is the form of complementary medicine most frequently used in Norway. In 1997, 37% of the Norwegian population reported that they had visited a homeopath 53. The number of children between 0 and 9 years of age that visited homeopaths increased from 10% in 1985 to 25% of patients visiting homeopaths in 1998.

The number of patients visiting homeopaths in Norway has steadily increased over the last 25 years:

• in 1975, 1 in 2000 Norwegians (0.05%) consulted homeopaths during 14 days of observation
• in 1985, 1 in 400 Norwegians (0.25%) consulted homeopaths during 14 days of observation
• in 1995, 1 in 50 Norwegians (1.83%) visited a homeopath in the previous 12 months.

Indicators of growth in use of homeopathy in the U.K. may be seen by the following:

• Over-The-Counter sales of homoeopathic remedies grew by 20% per annum in the late 1990’s.
• The waiting list at Glasgow Homeopathic Hospital has over 5000 patients on it.
• In 1997, referrals to the Royal London Homeopathic Hospital increased by 37%.
• Lothian Health District’s Dalkeith Clinic (a dedicated homeopathic referral centre, within the National Health System) developed a 2 year waiting list within its first two years of service.
(Source: Dr. R. Leckridge, past-president of the U.K. Faculty of Homeopathy).

The Chief Medical Officer of Scotland observed in his Health Bulletin of May 1993 that “alternative medicine is giving our patients something they value which we are failing to provide them with”.
A study from University College London gave the following four factors, in order of importance, that motivate patients to seek ‘complementary’ treatment 51:
1. Positive valuation of complementary treatment (it works)
2. Ineffective ‘orthodox’ treatment for their complaint
3. Concern about the adverse effects of orthodox medicine
4. Concerns about communication with doctors

Use of complementary modalities in South Africa has not been measured. The South African Health Products Association estimated in 1998 that the South African complementary medicines market was worth over R1,2 billion, when the overall health market was valued at R60 billion.

Professional acceptance of homeopathy by doctors

Eisenburg et al found that approximately 50% of medical schools in the USA offer some CAM training to their students 56.

A survey published in the British Homoeopathic Journal in 2000 showed that 28% of responding general practitioners in a ‘socio-economically’ deprived area (Liverpool) had been involved in homoeopathy the week before the survey was conducted 60.

Dr. J. Swayne, past Dean of the U.K. Faculty of Homeopathy, surveyed the use of homeopathic medicine in the U.K. health system in 1989, in which it was found that 10% of consultations by the medical doctors in the week of Dr. Swayne’s study were homeopathic 61. Additionally, 25% of general practice consultations by these doctors had homeopathic medicines used as part of the treatment.

The U.K. Faculty of Homeopathy has published the following examples of professional use of homeopathy in the U.K.: over 25% of Scottish G.P.’s have been trained in homeopathy at the Glasgow Homeopathic Hospital, 100% of all Glasgow general practices referred patients to the Glasgow Homeopathic Hospital in 1996/97 and Dalkeith clinic, outside of Glasgow, had a referral rate of 43% in its first month of operation from surrounding general practices.

The British Medical Association suggested the following ‘New approaches’ with regard to Complementary medicine:

i. “accredited postgraduate sessions be set up to inform clinicians on the techniques used by different therapies and the possible benefits for patients.”
ii. “consideration should be given to the inclusion of a familiarisation course on non-conventional therapies within the medical undergraduate curriculum .”

Increasing numbers of doctors in South Africa are interested in training in homeopathy. In 2006 approximately 80 South African medical doctors were also registered with the Allied Health Council as homeopaths.

References

55. Eisenberg, D.M. et al Unconventional medicine in the United States. Prevalence, costs and patterns of use JAMA 328(4):246-252

56. Eisenberg D.M. et al Trends in alternative medicine use in the United States, 1990-1997; results of a follow-up national survey. JAMA 1998 280 (18):1569-7

58. Thomas K.J. et al Use and expenditure on complementary medicine in England: a population based survey Compl Ther Med 2001 9(1):2-11

59. Menniti-Ippolito F. et al European Journal of Clinical Pharmacology 2002 58(1): 61-4

60. Perry R. Homeopathy and general practice: an urban perspective Br Homoeopath J 2000 89:13-16

61. Swayne J.M. Survey of the use of homeopathic medicine in the UK health system J R Coll Gen Pract 1989 39(329):503-6