Symptom Severity and Functional Status in Patients with Joint Pain, Back Pain, Headache, and Cough: A 10-year Retrospective Analysis of The Swaziland Homeopathy Project

Background and Aims: Over the past 10 years, the Swaziland Homeopathy Project has treated 9,866 patients in Eswatini and Mozambique in Southern Africa. The patients ranged in age from under 10 to over 79 years and 79% were female. Most lived in rural areas. The Project practices classical homeopathy.

Research Questions: What are the most common presenting symptoms? What are the characteristics of the patients reporting these symptoms? Do these patients report improvement in their symptom intensity and functional scores?

Method: We conducted a retrospective analysis using de-identified chart data. We collapsed similar symptoms into categories and ascertained the most frequent presenting complaints. Patients reported symptom severity on a visual analogue scale and overall function on a modified Karnofsky Performance Scale Index at each visit. We extracted the scores as reported on initial and follow-up visits.

Results: The most common symptoms treated were joint pain, back pain, headache, and cough. These four symptoms were reported at 33,649 visits, 50% of which have at least one follow-up. Of the patients seen for each of these complaints, 11–19% were male and 81–89% were female. Symptom severity improved in 49–63% of patients, with the complaint of headache showing the greatest improvement. Approximately 10% of patients reported a worsening of symptom severity. Regarding the functional scale, 41–49% of patients reported improvement, while 11% reported deterioration in their overall function regardless the symptom. Those who were treated for cough reported the greatest functional improvement.

Future Direction: In this retrospective chart analysis, patients reported improvement in their symptoms. Patients complaining of headache and cough possibly incurred the greatest benefit, so these symptoms will be the focus of the next phase. The future prospective study will investigate statistical significance and attempt to differentiate improvement beyond that expected from placebo.

Keywords: Symptoms, retrospective, pain, cough, Africa