Anthroposophic medicine is an integrative multimodal treatment system based on a holistic understanding of man and nature and of disease and treatment. It builds on a concept of four levels of formative forces and on the model of a three-fold human constitution. Anthroposophic medicine is integrated with conventional medicine in large hospitals and medical practices. It applies medicines derived from plants, minerals, and animals; art therapy, eurythmy therapy, and rhythmical massage; counseling; psychotherapy; and specific nursing techniques such as external embrocation. Anthroposophic healthcare is provided by medical doctors, therapists, and nurses. A Health-Technology Assessment Report and its recent update identified 265 clinical studies on the efficacy and effectiveness of anthroposophic medicine. The outcomes were described as predominantly positive. These studies as well as a variety of specific safety studies found no major risk but good tolerability. Economic analyses found a favorable cost structure. Patients report high satisfaction with anthroposophic healthcare.

Objective: Rhythmical massage therapy is used in 24 countries but has not yet been studied in outpatient settings. The objective was to study clinical outcomes in patients receiving rhythmical massage therapy for chronic diseases.Design: Prospective 4-year cohort study. Setting: Thirty-six (36) medical practices in Germany. Participants: Eighty-five (85) outpatients referred to rhythmical massage therapy. Outcome measures: Disease and Symptom Scores (physicians' and patients' assessment, respectively, 0-10) and SF-36. Disease Score was measured after 6 and 12 months, and other outcomes after 3, 6, 12, 18, 24, and 48 months.

Background: Depressive disorders are common, cause considerable disability, and do not always respond to standard therapy (psychotherapy, antidepressants). Anthroposophic treatment for depression differs from ordinary treatment in the use of artistic and physical therapies and special medication. We studied clinical outcomes of anthroposophic therapy for depression.

Compared to conventional treatment, anthroposophic treatment of primary care patients with acute respiratory and ear symptoms had more favourable outcomes, lower antibiotic prescription rates, less adverse drug reactions, and higher patient satisfaction.

BackgroundThe short consultation length in primary care is a source of concern, and the wish for more consultation time is a common reason for patients to seek complementary medicine. Physicians practicing anthroposophic medicine have prolonged consultations with their patients, taking an extended history, addressing constitutional, psychosocial, and biographic aspect of patients' illness, and selecting optimal therapy. In Germany, health benefit programs have included the reimbursement of this additional physician time. The purpose of this study was to describe clinical outcomes in patients with chronic diseases treated by anthroposophic physicians after an initial prolonged consultation.MethodsIn conjunction with a health benefit program in Germany, 233 outpatients aged 1–74 years, treated by 72 anthroposophic physicians after a consultation of at least 30 min participated in a prospective cohort study. Main outcomes were disease severity (Disease and Symptom Scores, physicians' and patients' assessment on numerical rating scales 0–10) and quality of life (adults: SF-36, children aged 8–16: KINDL, children 1–7: KITA). Disease Score was documented after 0, 6 and 12 months, other outcomes after 0, 3, 6, 12, 18, 24, and (Symptom Score and SF-36) 48 months.ResultsMost common indications were mental disorders (17.6% of patients; primarily depression and fatigue), respiratory diseases (15.5%), and musculoskeletal diseases (11.6%). Median disease duration at baseline was 3.0 years (interquartile range 0.5–9.8 years). The consultation leading to study enrolment lasted 30–60 min in 51.5% (120/233) of patients and > 60 min in 48.5%. During the following year, patients had a median of 3.0 (interquartile range 1.0–7.0) prolonged consultations with their anthroposophic physicians, 86.1% (167/194) of patients used anthroposophic medication.All outcomes except KITA Daily Life subscale and KINDL showed significant improvement between baseline and all subsequent follow-ups. Improvements from baseline to 12 months were: Disease Score from mean (standard deviation) 5.95 (1.74) to 2.31 (2.29) (p < 0.001), Symptom Score from 5.74 (1.81) to 3.04 (2.16) (p < 0.001), SF-36 Physical Component Summary from 44.01 (10.92) to 47.99 (10.43) (p < 0.001), SF-36 Mental Component Summary from 42.34 (11.98) to 46.84 (10.47) (p < 0.001), and KITA Psychosoma subscale from 62.23 (19.76) to 76.44 (13.62) (p = 0.001). All these improvements were maintained until the last follow-up. Improvements were similar in patients not using diagnosis-related adjunctive therapies within the first six study months.ConclusionPatients treated by anthroposophic physicians after an initial prolonged consultation had long-term reduction of chronic disease symptoms and improvement of quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that physician-provided anthroposophic therapy may play a beneficial role in the long-term care of patients with chronic diseases.

Hintergrund und Fragestellung: 2005 wurde ein «Health Technology Assessment»(HTA)-Bericht zu Wirksamkeit, Sicherheit, Wirtschaftlichkeit und Bedarf der Anthroposophischen Medizin (AM) erstellt. Im Kontext des «Schweizer Volksvotums pro Komplementärmedizin» (Mai 2009) erfolgte ein Update des HTA-Berichts. Design: Update des HTA-Berichts durch eine systematische Übersichtsarbeit. Methoden: Das Update wurde in Anlehnung an den bereits vorhandenen HTA-Bericht sowie entsprechend den Vorgaben des Schweizer Bundesamtes für Gesundheit durchgeführt. Nach klinischen Studien wurde systematisch in vier Datenbanken, in einer spezialisierten Zeitschrift und mit Hilfe umfassender Expertenkontakte gesucht. Studien wurden nach vorab definierten Kriterien ausgewählt, die Daten extrahiert und die Qualität individuell überprüft. Ergebnisse: 70 neue klinische Studien zur Wirksamkeit wurden gefunden. Damit liegen derzeit insgesamt 265 klinische Studien zur AM vor: 38 randomisierte Studien, 36 prospektive und 49 retrospektive, nichtrandomisierte, vergleichende Studien sowie 90 prospektive und 52 retrospektive Studien ohne Kontrollgruppe. Die Studien untersuchten ein weites Spektrum an AM-Therapien bei einer Vielzahl von Erkrankungen; das Gesamtsystem der AM untersuchten 38 Studien, in 10 Studien ging es um nichtpharmakologische Therapien, 133 befassten sich mit Misteltherapie bei Krebs und 84 untersuchten sonstige AM-Arzneitherapien. Die Studien zeigten in der Mehrzahl ein positives Ergebnis für AM. Die methodische Qualität der Studien variierte sehr; einige wiesen erhebliche Schwächen auf, andere waren sorgfältig durchgeführt. Die Praxisrelevanz war überwiegend hoch. Bei Beschränkung auf die qualitativ besseren Studien ergab sich ein positives Ergebnis für die AM. Nebenwirkungen und Risiken waren selten und im Schweregrad meist mild oder mäßig. Studien zur Sicherheit zeigten eine insgesamt gute Verträglichkeit. Schlussfolgerung: Studien unterschiedlichen Designs und unterschiedlicher Qualität beschreiben bei einer Vielzahl von Erkrankungen ein für die AM medizinisch gutes und für die Patienten zufriedenstellendes, sicheres und vermutlich auch kostengünstiges Behandlungsergebnis. Weiterführende qualitativ hochwertige Evaluationen sind wünschenswert.

Background: Many children with chronic disease use complementary therapies. Anthroposophic treatment for paediatric chronic disease is provided by physicians and differs from conventional treatment in the use of special therapies (art therapy, eurythmy movement exercises, rhythmical massage therapy) and special medications. We studied clinical outcomes in children with chronic diseases under anthroposophic treatment in routine outpatient settings.

Background:Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia.Patients and Methods:We conducted a prospective randomized open label pilot study with 95 patients randomized into three groups. Two groups received Iscador® M special (IMS) or a different mistletoe preparation, respectively, additionally to chemotherapy with six cycles of cyclophosphamide, adriamycin, and 5-fluoro-uracil (CAF). A control group received CAF with no additional therapy. Here we report the comparison IMS (n = 30) vs. control (n = 31). Quality of life including fatigue was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Neutropenia was defined as neutrophil counts <1,000/μl and assessed at baseline and one day before each CAF cycle.Results:In the descriptive analysis all 15 scores of the EORTC-QLQ-C30 showed better quality of life in the IMS group compared to the control group. In 12 scores the differences were significant (p < 0.02) and nine scores showed a clinically relevant and significant difference of at least 5 points. Neutropenia occurred in 3/30 IMS patients and in 8/31 control patients (p = 0.182).Conclusions:This pilot study showed an improvement of quality of life by treating breast cancer patients with IMS additionally to CAF. CAF-induced neutropenia showed a trend to lower frequency in the IMS group.