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Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Research article

Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study

Authors: Lamiae Grimaldi-Bensouda, Lucien Abenhaim, Jacques Massol, Didier Guillemot, Bernard Avouac, Gerard Duru, France Lert, Anne-Marie Magnier, Michel Rossignol, Frederic Rouillon, Bernard Begaud, for the EPI3-LA-SER group

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

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Abstract

Background

The purpose of the study was to compare utilization of conventional psychotropic drugs among patients seeking care for anxiety and depression disorders (ADDs) from general practitioners (GPs) who strictly prescribe conventional medicines (GP-CM), regularly prescribe homeopathy in a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho).

Methods

This was one of three epidemiological cohort studies (EPI3) on general practice in France, which included GPs and their patients consulting for ADDs (scoring 9 or more in the Hospital Anxiety and Depression Scale, HADS). Information on all medication utilization was obtained by a standardised telephone interview at inclusion, 1, 3 and 12 months.

Results

Of 1562 eligible patients consulting for ADDs, 710 (45.5 %) agreed to participate. Adjusted multivariate analyses showed that GP-Ho and GP-Mx patients were less likely to use psychotropic drugs over 12 months, with Odds ratio (OR) = 0.29; 95 % confidence interval (CI): 0.19 to 0.44, and OR = 0.62; 95 % CI: 0.41 to 0.94 respectively, compared to GP-CM patients. The rate of clinical improvement (HADS <9) was marginally superior for the GP-Ho group as compared to the GP-CM group (OR = 1.70; 95 % CI: 1.00 to 2.87), but not for the GP-Mx group (OR = 1.49; 95 % CI: 0.89 to 2.50).

Conclusions

Patients with ADD, who chose to consult GPs prescribing homeopathy reported less use of psychotropic drugs, and were marginally more likely to experience clinical improvement, than patients managed with conventional care. Results may reflect differences in physicians’ management and patients’ preferences as well as statistical regression to the mean.
Literature
1.
go back to reference Grimaldi-Bensouda L, Begaud B, Lert F, Rouillon F, Massol J, Guillemot D, Avouac B, Duru G, Magnier AM, Rossignol R, Abenhaim L. Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices. BMJ Open. 2011;1:e000215. Grimaldi-Bensouda L, Begaud B, Lert F, Rouillon F, Massol J, Guillemot D, Avouac B, Duru G, Magnier AM, Rossignol R, Abenhaim L. Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices. BMJ Open. 2011;1:e000215.
2.
go back to reference Lecrubier Y. The burden of depression and anxiety in general medicine. J Clin Psychiatry. 2001;62 Suppl 8:4–9.PubMed Lecrubier Y. The burden of depression and anxiety in general medicine. J Clin Psychiatry. 2001;62 Suppl 8:4–9.PubMed
4.
go back to reference National Collaborating Centre for Mental Health (UK). Common mental health disorders: identification and pathways to care. Leicester: British Psychological Society; 2011. National Collaborating Centre for Mental Health (UK). Common mental health disorders: identification and pathways to care. Leicester: British Psychological Society; 2011.
5.
go back to reference Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 2010;303:47–53.CrossRefPubMedPubMedCentral Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 2010;303:47–53.CrossRefPubMedPubMedCentral
6.
go back to reference Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J. 2012;12:45–56.PubMedPubMedCentral Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J. 2012;12:45–56.PubMedPubMedCentral
7.
go back to reference Grolleau A, Bégaud B, Verdoux H. Characteristics associated with use of homeopathic drugs for psychiatric symptoms in the general population. Eur Psychiatry. 2013;28:110–6.CrossRefPubMed Grolleau A, Bégaud B, Verdoux H. Characteristics associated with use of homeopathic drugs for psychiatric symptoms in the general population. Eur Psychiatry. 2013;28:110–6.CrossRefPubMed
8.
go back to reference Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for anxiety and anxiety disorders: a systematic review of the research. Homeopathy. 2006;95:151–62.CrossRefPubMed Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for anxiety and anxiety disorders: a systematic review of the research. Homeopathy. 2006;95:151–62.CrossRefPubMed
9.
go back to reference Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for depression: a systematic review of the research evidence. Homeopathy. 2005;94:153–63.CrossRefPubMed Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for depression: a systematic review of the research evidence. Homeopathy. 2005;94:153–63.CrossRefPubMed
10.
go back to reference Davidson JR, Crawford C, Ives JA, Jonas WB. Homeopathic treatments in psychiatry: a systematic review of randomized placebo-controlled studies. J Clin Psychiatry. 2011;72:795–805.CrossRefPubMed Davidson JR, Crawford C, Ives JA, Jonas WB. Homeopathic treatments in psychiatry: a systematic review of randomized placebo-controlled studies. J Clin Psychiatry. 2011;72:795–805.CrossRefPubMed
11.
go back to reference Thachil AF, Mohan R, Bhugra D. The evidence base of complementary and alternative therapies in depression. J Affect Disord. 2007;97:23–35.CrossRefPubMed Thachil AF, Mohan R, Bhugra D. The evidence base of complementary and alternative therapies in depression. J Affect Disord. 2007;97:23–35.CrossRefPubMed
12.
go back to reference Kooreman P, Baars EW. Patients whose GP knows complementary medicine tend to have lower costs and live longer. Eur J Health Econ. 2012;13:769–76.CrossRefPubMed Kooreman P, Baars EW. Patients whose GP knows complementary medicine tend to have lower costs and live longer. Eur J Health Econ. 2012;13:769–76.CrossRefPubMed
13.
go back to reference MacLennan AH, Wilson DH, Taylor AW. The escalating cost and prevalence of alternative medicine. Prev Med. 2002;35:166–73.CrossRefPubMed MacLennan AH, Wilson DH, Taylor AW. The escalating cost and prevalence of alternative medicine. Prev Med. 2002;35:166–73.CrossRefPubMed
14.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed
15.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52:69–77.CrossRefPubMed Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52:69–77.CrossRefPubMed
16.
go back to reference Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8.CrossRefPubMed Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8.CrossRefPubMed
17.
go back to reference Grimaldi-Bensouda L, Rossignol M, Aubrun E, El Kerri N, Benichou J, Abenhaim L, et al. Agreement between patients’ self-report and physicians’ prescriptions on cardiovascular drug exposure: the PGRx database experience. Pharmacoepidemiol Drug Saf. 2010;19:591–5. Grimaldi-Bensouda L, Rossignol M, Aubrun E, El Kerri N, Benichou J, Abenhaim L, et al. Agreement between patients’ self-report and physicians’ prescriptions on cardiovascular drug exposure: the PGRx database experience. Pharmacoepidemiol Drug Saf. 2010;19:591–5.
18.
go back to reference Grimaldi-Bensouda L, Rossignol M, Aubrun E, Benichou J, Abenhaim L, the GRx Study Group. Agreement between patients’ self-report and physicians’ prescriptions on nonsteroidal anti-inflammatory drugs and other drugs used in musculoskeletal disorders: the international Pharmacoepidemiologic General Research eXtension database. Pharmacoepidemiol Drug Saf. 2012;21:753–9.CrossRefPubMed Grimaldi-Bensouda L, Rossignol M, Aubrun E, Benichou J, Abenhaim L, the GRx Study Group. Agreement between patients’ self-report and physicians’ prescriptions on nonsteroidal anti-inflammatory drugs and other drugs used in musculoskeletal disorders: the international Pharmacoepidemiologic General Research eXtension database. Pharmacoepidemiol Drug Saf. 2012;21:753–9.CrossRefPubMed
19.
go back to reference Law M, Naughton MT, Dhar A, Barton D, Dabscheck E. Validation of two depression screening instruments in a sleep disorders clinic. J Clin Sleep Med. 2014;10:683–8.PubMedPubMedCentral Law M, Naughton MT, Dhar A, Barton D, Dabscheck E. Validation of two depression screening instruments in a sleep disorders clinic. J Clin Sleep Med. 2014;10:683–8.PubMedPubMedCentral
20.
go back to reference Grimaldi-Bensouda L, Engel P, Massol J, Guillemot D, Avouac B, Duru G, Lert F, Magnier AM, Rossignol M, Rouillon F, Abenhaim L, Begaud B. Who seeks primary care for sleep, anxiety and depressive disorders from physicians prescribing homeopathic and other complementary medicine? Results from the EPI3 population survey. BMJ Open. 2012;2:e001498. Grimaldi-Bensouda L, Engel P, Massol J, Guillemot D, Avouac B, Duru G, Lert F, Magnier AM, Rossignol M, Rouillon F, Abenhaim L, Begaud B. Who seeks primary care for sleep, anxiety and depressive disorders from physicians prescribing homeopathic and other complementary medicine? Results from the EPI3 population survey. BMJ Open. 2012;2:e001498.
21.
go back to reference Hermens ML, van Hout HP, Terluin B, Adèr HJ, Penninx BW, van Marwijk HW, Bosmans JE, van Dyck R, de Haan M. Clinical effectiveness of usual care with or without antidepressant medication for primary care patients with minor or mild-major depression: a randomized equivalence trial. BMC Med. 2007;5:36.CrossRefPubMedPubMedCentral Hermens ML, van Hout HP, Terluin B, Adèr HJ, Penninx BW, van Marwijk HW, Bosmans JE, van Dyck R, de Haan M. Clinical effectiveness of usual care with or without antidepressant medication for primary care patients with minor or mild-major depression: a randomized equivalence trial. BMC Med. 2007;5:36.CrossRefPubMedPubMedCentral
22.
go back to reference National Institute for Health and Care Excellence. [Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults: Management in primary, secondary and community care]. [CG113]. London: National Institute for Health and Care Excellence; 2011 [http://www.nice.org.uk/Guidance/CG113]. National Institute for Health and Care Excellence. [Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults: Management in primary, secondary and community care]. [CG113]. London: National Institute for Health and Care Excellence; 2011 [http://​www.​nice.​org.​uk/​Guidance/​CG113].
23.
go back to reference Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):55–64. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):55–64.
24.
go back to reference Lin EH, Von Korff M, Ludman EJ, Rutter C, Bush TM, Simon GE, Unützer J, Walker E, Katon WJ. Enhancing adherence to prevent depression relapse in primary care. Gen Hosp Psychiatry. 2003;25:303–10.CrossRefPubMed Lin EH, Von Korff M, Ludman EJ, Rutter C, Bush TM, Simon GE, Unützer J, Walker E, Katon WJ. Enhancing adherence to prevent depression relapse in primary care. Gen Hosp Psychiatry. 2003;25:303–10.CrossRefPubMed
26.
go back to reference Spence DS, Thompson EA, Barron SJ. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med. 2005;11:793–8.CrossRefPubMed Spence DS, Thompson EA, Barron SJ. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med. 2005;11:793–8.CrossRefPubMed
27.
go back to reference Güthlin C, Lange O, Walach H. Measuring the effects of acupuncture and homoeopathy in general practice: an uncontrolled prospective documentation approach. BMC Public Health. 2004;4:6.CrossRefPubMedPubMedCentral Güthlin C, Lange O, Walach H. Measuring the effects of acupuncture and homoeopathy in general practice: an uncontrolled prospective documentation approach. BMC Public Health. 2004;4:6.CrossRefPubMedPubMedCentral
28.
go back to reference Van Wassenhoven M, Ives G. An observational study of patients receiving homeopathic treatment. Homeopathy. 2004;93:3–11.CrossRefPubMed Van Wassenhoven M, Ives G. An observational study of patients receiving homeopathic treatment. Homeopathy. 2004;93:3–11.CrossRefPubMed
29.
go back to reference Golden AG, Qiu D, Roos BA. Medication assessments by care managers reveal potential safety issues in homebound older adults. Ann Pharmacother. 2011;45:492–8.CrossRefPubMed Golden AG, Qiu D, Roos BA. Medication assessments by care managers reveal potential safety issues in homebound older adults. Ann Pharmacother. 2011;45:492–8.CrossRefPubMed
30.
go back to reference Gaynes BN, Rush AJ, Trivedi MH, Wisniewski SR, Balasubramani GK, Spencer DC, Petersen T, Klinkman M, Warden D, Nicholas L, Fava M. Major depression symptoms in primary care and psychiatric care settings: a cross-sectional analysis. Ann Fam Med. 2007;5:126–34.CrossRefPubMedPubMedCentral Gaynes BN, Rush AJ, Trivedi MH, Wisniewski SR, Balasubramani GK, Spencer DC, Petersen T, Klinkman M, Warden D, Nicholas L, Fava M. Major depression symptoms in primary care and psychiatric care settings: a cross-sectional analysis. Ann Fam Med. 2007;5:126–34.CrossRefPubMedPubMedCentral
32.
go back to reference Sanderson K, Andrews G. Prevalence and severity of mental health-related disability and relationship to diagnosis. Psychiatr Serv. 2002;53:80–6.CrossRefPubMed Sanderson K, Andrews G. Prevalence and severity of mental health-related disability and relationship to diagnosis. Psychiatr Serv. 2002;53:80–6.CrossRefPubMed
33.
go back to reference Wang HM, Beyer M, Gensichen J, Gerlach FM. Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008;8:246.CrossRefPubMedPubMedCentral Wang HM, Beyer M, Gensichen J, Gerlach FM. Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008;8:246.CrossRefPubMedPubMedCentral
Metadata
Title
Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study
Authors
Lamiae Grimaldi-Bensouda
Lucien Abenhaim
Jacques Massol
Didier Guillemot
Bernard Avouac
Gerard Duru
France Lert
Anne-Marie Magnier
Michel Rossignol
Frederic Rouillon
Bernard Begaud
for the EPI3-LA-SER group
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1104-2

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