A patient reported outcome measure in homeopathic clinical practice for long-term conditions

Background: This study was initiated as part of a quality improvement audit process to create standards around goal setting with our patients to understand and improve outcomes of homeopathic treatment.

Method: We used the Measure Yourself Medical Outcome Profile (MYMOP2) as a tool to assist clinicians in setting the treatment goals across a wide range of diagnoses and other complaints in routine clinical practice at the Bristol Homeopathic Hospital. The data collected from the MYMOP2 is of significance in its own right and the results are now reported in this paper.

Results: A total of 198 patients with a wide range of complaints attended one to five consultations with 20 homeopathic doctors. Diagnostic categories were most commonly neoplasms (16.7%), psychological (13.9%) and genitourinary complaints (12.3%), with 66.7% suffering from these problems for at least one year. The three symptoms that bothered patients the most were pain, mental symptoms and tiredness/fatigue. A paired-samples t-test using an intention-to-treat analysis showed that the MYMOP2 profile score improved from 4.25 (IQR 3.50–5.00), with a mean change of 1.24 (95% CI 1.04, 1.44) from the first to the last consultation (p < 0.001). Results were statistically significant both for completers (n = 91) (p < 0.001) and non-completers (n = 107) (p < 0.001) using last-observation-carried-forward, although completers did better than non-completers (p < 0.001). The overall clinical significance of improvements was at least moderate. A repeated measures ANOVA test also showed statistically significant improvements (p < 0.001).

Conclusion: The MYMOP2 results add to a growing body of observational data which demonstrates that when patients with long term conditions come under homeopathic care their presenting symptoms and wellbeing often improve. Offering a low cost high impact intervention to extend the range of choice to patients and to support self-care could be an important part of the NHS.

Keywords

Homeopathy - MYMOP - Long term conditions - Self-care

^a At time of study.

• References

• 1 Anelli M., Scheepers L., Sermeus G., Van Wassenhoven M. Homeopathy and health related quality of life: a survey in six European countries. Homeopathy 91 (01) 2002; 18-21.
• 2 Bawden S. Running an NHS community homeopathy clinic – 10-year anniversary 2001–2011. Homeopathy 2012; 101: 51-56.
• 3 Brown C., Alcoe J. The heart of wellbeing: a self-help approach to recovering, sustaining and improving wellbeing. J Holist Healthc 7 (01) 2010; 24-28.
• 4 Chung V.C., Wong V.C., Lau C.H. et al. Using Chinese version of MYMOP in Chinese medicine evaluation: validity, responsiveness and minimally important change. Health Qual Life Outcomes 2010; 8: 111 10.1186/1477-7525-8-111.
• 5 Clover A. Patient benefit survey: Tunbridge Wells Homoeopathic Hospital. Br Homeopath J 89 (02) 2000; 68-72.
• 6 Endrizzi C., Rossi E. Patient compliance with homeopathic therapy. Homeopathy 2006; 95: 206-214.
• 7 Goossens M., Laekeman G., Aertgeerts B. et al. Evaluation of the quality of life after individualized homeopathic treatment for seasonal allergic rhinitis. A prospective, open, non-comparative study. Homeopathy 98 (01) 2009; 11-16.
• 8 Güthlin C., Lange O., Walach H. Measuring the effects of acupuncture and homeopathy in general practice: an uncontrolled prospective documentation approach. BMC Public Health 2004; 4: 6.
• 9 Guyatt G.H., Juniper E.F., Walter S.D., Griffith L.E., Goldstein R.S. Interpreting treatment effects in randomised trials. BMJ 316 7132 1998; 690-693.
• 10 Hill S., Eckett M.J., Paterson C., Harkness E.F. A pilot study to evaluate the effects of floatation spa treatment on patients with osteoarthritis. Complement Ther Med 7 (04) 1999; 235-238.
• 11 Hughes S.L., Smith A.C., Relton C. Homeopathy service in an NHS hospital breast cancer clinic: outcome study. Breast Cancer Res 10 (02) 2008; P93 Available at: http://breast-cancer-research.com/content/pdf/bcr1977.pdf.
• 12 Kimberlee R. Measuring the economic impact of Wellspring Healthy Living Centre's Social Prescribing Wellbeing Programme for low level mental health issues encountered by GP services. 2014.
• 13 Kline P. The handbook of psychological testing. 2nd edn Routledge: London: 1999.
• 14 Mullen P.D. Compliance becomes concordance. BMJ 1997; 314: 691.
• 15 Naylor C., Imison C., Addicott R. et al. Transforming our health care system. Ten priorities for commissioners. The King’s Fund: 2013. Available at: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/10PrioritiesFinal2.pdf.
• 16 Paterson C., Britten N. In pursuit of patient-centred outcomes: a qualitative evaluation of the ‘Measure Yourself Medical Outcome Profile’. J Health Serv Res Policy 5 (01) 2000; 27-36.
• 17 Paterson C., Langan C.E., McKaig G.A. et al. Assessing patient outcomes in acute exacerbations of chronic bronchitis: the Measure Your Medical Outcome Profile (MYMOP), Medical Outcomes Study 6-item general health survey (MOS-6A), and EuroQol (EQ-5D). Qual Life Res 2000; 9: 521-527.
• 18 Paterson C., Vindigni D., Polus B., Browell T., Edgecombe G. Evaluating a massage therapy training and treatment programme in a remote Aboriginal community. Complement Ther Clin Pract 14 (03) 2008; 158-167.
• 19 Paterson C., Unwin J., Joire D. Outcomes of traditional Chinese medicine (traditional acupuncture) treatment for people with long-term conditions. Complement Ther Clin Pract 16 (01) 2010; 3-9.
• 20 Paterson C. Measuring outcomes in primary care: a patient generated measure, MYMOP, compared with the SF-36 health survey. BMJ 213 7037 1996; 1016-1020.
• 21 Reilly D., Mercer S.W., Bikker A.P., Harrison T. Outcome related to impact on daily living: preliminary validation of the ORIDL instrument. BMC Health Serv Res 2007; 7: 139.
• 22 Richardson W.R. Patient benefit survey: Liverpool Regional Department of Homoeopathic Medicine. Br Homeopath J 90 (03) 2001; 158-162.
• 23 Rossi E., Endrizzi C., Panozzo M.A., Bianchi A., Da Frè M. Homeopathy in the public health system: a seven-year observational study at Lucca Hospital (Italy). Homeopathy 98 (03) 2009; 142-148.
• 24 Spence D.S., Thompson E.A., Barron S.J. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med 11 (05) 2005; 793-798.
• 25 Steinsbekk A., Lüdtke R. Patients' assessments of the effectiveness of homeopathic care in Norway: a prospective observational multicentre outcome study. Homeopathy 94 (01) 2005; 10-16.
• 26 Thompson E.A., Mathie R.T., Baitson E.S. et al. Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals. Homeopathy 97 (03) 2008; 114-121.
• 27 Witt C.M., Lüdtke R., Baur R., Willich S.N. Homeopathic medical practice: long-term results of a Cohort Study with 3981 patients. BMC Public Health 2005; 51: 115 10.1186/1471-2458-5-115.
• 28 Witt C.M., Lüdtke R., Mengler N., Willich S.N. How healthy are chronically ill patients after eight years of homeopathic treatment? Results from a long term observational study. BMC Public Health 2008; 8: 413 10.1186/1471-2458-8-413.