Sage Journals: Discover world-class research

Abstract

Spanish

French

BACKGROUND

There is growing interest in complementary medicine worldwide and a corresponding need to know how patients and practitioners interact.

OBJECTIVE

To chart the use of complementary medications compared with conventional treatments among practitioners and patients in Germany.

METHODS

Comparative analysis of patients' data from a prospective cohort study of 4178 patients presenting with chronic as well as acute symptoms by 218 practitioners at 218 centers in all German federal states between 2001 and 2002. Practices focused on either conventional medicine, complementary medicine, or both. Data were gathered on prescription patterns, treatment satisfaction and adherence, and the degree of patient involvement in treatment decisions.

RESULTS

Complementary medicine was preferentially prescribed over conventional medicine in patients <18 and >65 years old, in women, and in patients with chronic symptoms. Patients receiving complementary medications had, on average, higher rates of accompanying illnesses, received more preparations, and were more closely involved in the decision process than patients prescribed conventional therapies. The decision to use complementary medicine was based on both the patient's and the practitioner's wishes in 40.8% of the cases compared with 25.8% of the cases of conventional therapies. Tolerability and satisfaction with treatment appeared greater with complementary than with conventional therapies.

CONCLUSION

Complementary medicine is generally well established in Germany, apparently in a dialogue with conventional medicine. Patients receiving complementary medicine appear to be more closely involved in the decision process and more satisfied with treatments than conventionally treated patients.

Keywords

adherence complementary medicine Germany homeopathy prescription patterns

Get full access to this article

View all access options for this article.

References

1. Morgan

Complementary medicine. New approaches to good practices. London: Oxford University Press, 1993.

2. National Institutes of Health. National Center for Complementary and Alternative Medicine. www.nccam.nih.gov (accessed 2003 May 28).

3. Barrett

Complementary and alternative medicine: what's it all about?

Wis Med J 2001;100:20–6.

4. Eisenberg

Davis

Ettner

Appel

Wilkey

Van Rompay

Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998;280:1569–75.

5. Thomas

Nicholl

Coleman

Use and expenditure on complementary medicine in England: a population based survey. Complement Ther Med 2001;9:2–11.

6. Kayne

Developing outcome measures for homoeopathic remedies bought OTC In: Proceedings of the 52nd Congress of the Liga Medico-rum Homoeopathica Internationalis, Seattle, 1997:23–5.

7. Martin

Jordan

Vassar

White

DB.

Herbal and nonherbal alternative medicine use in northwest Ohio. Ann Pharmacother 2002;36:1862–9. DOI 10.1345/aph.1A215.

8. Astin

JA.

Why patients use alternative medicine: results of a national study. JAMA 1998;279:1548–53.

9. Bausell

Lee

Berman

BM.

Demographic and health-related correlates to visits to complementary and alternative medical providers. Med Care 2001;39:190–6.

10.

10. Druss

Rosenheck

RA.

Association between use of unconventional therapies and conventional medical services. JAMA 1999;282:651–6.

11.

11. Tuffs

Three out of four Germans have used complementary or natural remedies. BMJ 2002;325:990.

12.

12. Rosenbaum

The central role of the propensity score in observational studies for causal effects. Biometrica 1983;70:41–55.

13.

13. Fleiss

The design and analysis of clinical experiments. New York: John Wiley & Sons, 1996.

14.

14. Conforti

Bertani

Metelmann

Chirumbolo

Lussignoli

Bellavite

Experimental studies of the anti-inflammatory activity of a homeopathic preparation. Biol Ther 1997;15:28–31.

15.

15. Haltenhof

Hesse

Buhler

KE.

[Evaluation and utilization of complementary medical procedures—a survey of 793 physicians in general practice and the clinic] German. Gesundheitswesen 1995;57:192–5.

16.

16. Robert Koch-Institut/Statistisches Bundesamt. lnanspruchnahme alternativer Methoden in der Medizin. vol. 9. Berlin: Verlag Robert Koch-Institut, 2002.

17.

17. The homeopathic pharmacopoeia of the United States (HPUS). 8th ed. Falls Church, VA, 1979.

18.

18. De Smet

PA.

Herbal remedies. N Engl J Med 2002;347:2046–56.

19.

19. European Commission. Directive on traditional herbal medicinal products. Amendment to Directive 2001/83/EC Brussels: Commission of the European Communities, 2002.

20.

20. Talalay

Talalay

The importance of using scientific principles in the development of medicinal agents from plants. Acad Med 2001;76:238–47.

21.

21. Marcus

Grollman

Botanical medicines—the need for new regulations. N Engl J Med 2002;347:2073–5.

22.

22. Britton

McKee

Black

McPherson

Sanderson

Bain

Choosing between randomised and non-randomised studies: a systematic review. Health Technol Assess 1998;2:i–iv, 1–124.

23.

23. Benson

Hartz

AJ.

A comparison of observational studies and randomized, controlled trials. N Engl J Med 2000;342:1878–86.

24.

24. Hansson

“Why don't you do as I tell you?” Compliance and anti-hypertensive regimens. Int J Clin Pract 2002;56:191–6.

Complementary Medicine Prescription Patterns in Germany