Is homeopathic treatment similar to placebo treatment

Homeopathy: Belief or Knowledge?

Up to 80 percent of all patients in Austria use a homeopathic method at least once a year. Opinions are divided as to effectiveness. In any case, experts admit that more studies on homeopathy are necessary. The problem with this: the high costs.
By Elisabeth Gerstendorfer

The homeopathic substance is always aimed at a specific patient. It is not diagnosis-oriented, but rather patient-oriented, in that one does not treat asthma, but a patient with asthma who may also have a rash, diarrhea and mood disorders at the same time, "says Univ. Prof. Michael Frass, Vice President of the Medical Association for Classical Homeopathy and President of the Umbrella Association of Austrian Doctors for Holistic Medicine.

Few studies

While the majority of patients are fond of homeopathy - up to 80 percent of patients in Austria use a homeopathic method at least once a year - the opinions among doctors are still divided. Above all, the lack of evidence of effectiveness through clinical studies is criticized. For Frass, several meta-analyzes show a tendency that the effects of homeopathy go beyond the placebo effect. The last major study was published in the Lancet in 2005. Frass: “While the statements made by the authors speak against the effectiveness of homeopathy, a precise scientific analysis shows the exact opposite. In my opinion, the argument of the placebo effect is no longer tenable. "

According to Frass, improvements in intensive care patients, small children and animals also suggest that homeopathy goes beyond placebo. “I agree that we need more studies on homeopathy. Unfortunately, the possibilities for carrying out such large-scale studies are limited, ”says Frass. It is also difficult to get data, because homeopathy is based on the individual and “cannot be easily compared”, says Frass, who has headed the special outpatient clinic “Homeopathy for Malignant Diseases” at Vienna General Hospital since 2004. Study designs are feasible, but the costs are too high and there are no donors.

Cohort studies that were carried out outside of experimental clinical research at university clinics in homeopathic practices with several thousand patients showed that those who suffered from chronic diseases such as neurodermatitis, allergies and headaches for many years experienced significant improvements through homeopathic methods. “Even in studies in which homeopathy and conventional medicine are compared under everyday conditions, similar treatment results are available for both systems. Obviously there is a benefit. Ultimately, it is disputed to what extent this benefit is based on an effect of the highly potent drugs or on other factors such as placebo effects or therapeutic effects through a successful doctor-patient relationship, "says Michael Teut, specialist in general medicine and homeopathy at the University outpatient clinic for naturopathy at the Charité University Hospital in Berlin. There are more than 200 randomized and partly placebo-controlled studies on homeopathy. Overall, however, the results are not unambiguous, "neither to support the placebo hypothesis nor the thesis of a specific effectiveness of the highly potent drugs," explains Teut.

"Just try"

Homeopathy can be used in Austria as a complementary method to conventional therapy. Homeopathic practice is particularly successful in the case of cardiovascular diseases as well as diseases of the gastrointestinal tract, the respiratory tract, migraines and headaches as well as rheumatic complaints. Also
For some diseases such as allergic rhinitis, diarrhea in children or fibromyalgia, the data currently speak for the effectiveness of homeopathy,
reports Teut.

At the special outpatient clinic “Homeopathy for Malignant Diseases” at the Vienna General Hospital, homeopathic methods are used to reduce side effects in patients with chemotherapy, to treat secondary diseases and to improve the quality of life. For some subjective symptoms, homeopathy is the only effective method - if conventional therapy does not work. The health insurance companies do not currently reimburse homeopathic treatments in Austria, but depending on the health insurance company, a portion of the costs for oncological patients is reimbursed. This is different in Switzerland: after a referendum, homeopathic services have been provisionally reimbursed by the compulsory health insurance scheme until the end of 2017 under certain conditions since January 1, 2012.

In Austria, the debate about homeopathy is increasing. At medical universities, for example, there is a small number of compulsory lectures and electives on the subject. Around 800 doctors with the additional diploma “Homeopathy” are registered with the two Austrian homeopathic societies. Frass: “Homeopathy and conventional medicine are not a contradiction in terms. Even if one cannot simply explain the effect of homeopathic methods, dialogues should be held and methods tried out. I am a skeptic myself, but it's nice to see patients get better with homeopathy. "


Homeopathy compact

“Treating similar things through similar things” - that is the principle of homeopathy that its developer, the German doctor and chemist Samuel Hahnemann, established at the beginning of the 19th century. He observed that certain herbs could cause symptoms in healthy people similar to those in sick people. If he administered these substances to the sick person, they could contribute to his healing process. Hahnemann later developed a dilution method, potentization, in which the substances were diluted in several steps with water or alcohol and gradually shaken or rubbed with lactose.

Depending on the dilution, a distinction is made between C- (1: 100), D- (1:10), LM- and Q-potencies (1: 50,000). Around 1,000 different homeopathic remedies are available in the form of tablets, drops, powders, juices or tiny spheres (globules).

© Österreichische Ärztezeitung No. 4 / 25.02.2013

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