Weatherley-Jones E; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2002; 18: abstract no. 346.

University of Sheffield, Regent Court, Sheffield, e.weatherley-jones@sheffield.ac.uk

BACKGROUND/OBJECTIVES: Randomised, controlled double-blind trials (RCT) of homeopathic treatment that incorporate the rigorous features of RCTs while retaining the integrity of the therapy can be designed and have been implemented in a number of published studies. The experiences of prescribing homeopaths in such trials have brought to light an aspect of such RCTs that may challenge the accuracy of the underlying assumptions of the model of the healing process that is implicit in RCT designs. METHODS: In trials of orthodox medicine, a patient's lack of reaction to a medication has no implications for the competence of the prescribing clinician. Homeopathic medicine is prescribed on an individual basis, determined by the homeopath's perception and interpretation of pertinent symptoms of the case. Therefore, in homeopathic practice and trials of homeopathic practice, a patient's lack of reaction to medication has a number of possible interpretations, including that the homeopath has prescribed an inappropriate medication. Continuing case management and prescribing are based on patients' reactions to homeopathic medicine. The inclusion of a placebo arm in a trial of homeopathic medicine (in the context of homeopathic consultations) has implications for the practice of the prescribing homeopaths. These implications extend not only to the potential effect on the homeopath's confidence in their prescriptions, but also to the degree to which the therapeutic relationship between homeopath and patient may be affected. DISCUSSION: Reflections of homeopaths treating patients in a trial of homeopathic treatment that included a placebo arm are presented. The impact that the placebo arm had on their homeopathic prescribing and trial execution is considered. The potential effect of patients' reactions on the homeopaths' confidence is used to illustrate a model of the healing process that includes such interaction effects. The RCT as a true test of homeopathic treatment is questioned.

Publication Types:

• Meeting Abstracts

Keywords:

• Clinical Trials as Topic
• Double-Blind Method
• Homeopathy
• Humans
• Placebos
• Prescriptions, Drug
• Randomized Controlled Trials as Topic
• Research Design
• Self Medication
• drug therapy
• instrumentation
• methods
• therapy
• hsrmtgs

Other ID:

• GWHSR0003283

UI: 102274962

From Meeting Abstracts