Moebus S, Lehmann N, Hoffmann B, Jockel K; 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. 215.
Institute for Medical Informatics, Biometry and Epidemiology, University of Essen, Medical Faculty, Hufelandstr. 55, 45122 Essen, Germany, susanne.moebus@uni-essen.de
BACKGROUND/OBJECTIVES: The original purpose of this longterm observational study is to evaluate the general effectiveness of complementary and alternative medical therapies on chronic diseases within ambulatory care. In this contribution we analyze the pattern of medical prescription of the involved general practitioners. METHODS: The study, sponsored by 22 German company health insurances, includes about 1200 volunteers. The inclusion criteria comprised membership of the involved health insurances and chronic diseases with low chance to be improved with conventional treatments. The patients' health insurance data on medication, hospitalization, etc. are sampled retrospectively and prospectively (up to 10 years). Case reports are obtained from physicians, and questionnaires are filled out by patients before and after treatment, and 11/2 years later. Prescriptions are analyzed regarding age, gender, diagnosis, health status, and costs. Location parameters are represented with their 95% confidence intervals (CI). Data from the German Medication report (GKV NRW, Arzneimittelreport 2000) are used for comparison purposes. RESULTS: About 40 CAM practitioners prescribed 15.000 single medications with overall costs of more than [EUR] 280.000. Mean prescription costs/year/patient in the study group are [EUR] 318 (95%CI [EUR] 283-356) and are somewhat higher compared to conventional medicine ([EUR] 286). Interestingly a considerable proportion of the patients (26%) didn't receive any medication during the whole duration of treatment (mean=1.8 years). Of the 100 drug groups prescribed most often, homoeopathics (15.2%, [EUR] 24.000), vitamins and minerals (8.8%, [EUR] 20.500), bacteria lysates (7.5%, [EUR] 23.500) and phytotherapeutics (6.7%, [EUR] 12.800) rank first. Analgetics on the other hand play a minor role, although dorsopathies, arthropathies and migraine/headache are the major diagnosis groups. Besides the CAM therapies modern conventional pharmaceutical therapies were used by the pracititioners, e.g. Aarane, a bronchodilatator for asthma. DISCUSSION: Although the participants of the study are not a random sample from users of CAM, we have good evidence that the participants are typical for patients who change from conventional medicine to CAM. For the first time a comprehensive picture of the prescription pattern of CAM practitioners for these patients can be drawn. Furthermore these data can be linked to other predefined health indicators like development of health status or sickness absence. Altogether the results of the study show a manifest influence of CAM interventions on the health status of the patients suffering from chronic diseases. This should urge actors of the health system to pay more attention to the benefits and drawbacks of CAM.
Publication Types:
Keywords:
- Chronic Disease
- Complementary Therapies
- Health Status
- Hospitalization
- Humans
- Outcome Assessment (Health Care)
- Physicians
- Questionnaires
- hsrmtgs
Other ID:
UI: 102274831
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