Complementary and alternative medicine (CAM) as part of primary health care in Germany–comparison of patients consulting general practitioners and CAM practitioners: a cross-sectional study

Krug, Katja; Herrmann, Kathrin; Joos, Stefanie

doi:10.1186/s12906-016-1402-8

Cited by 22 publications

(23 citation statements)

References 22 publications

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“…At its initial development, cogent criticisms were made of the derivation and mathematical principles underlying MYMOP [ 34 , 35 ]. Since then, MYMOP has been widely used and further validated, in particular with patients accessing alternative and complementary therapies, such as acupuncture or homeopathy [ 36 – 38 ].…”

Section: Methodsmentioning

confidence: 99%

Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study

2018

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BackgroundStandardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own words) and transitional PROMs (in which respondents directly rate change over a period). The objective of this study was to test qualitatively, through cognitive interviews, two PROMs, one using each respective format.MethodsThe individualised PROM selected was the Measure Yourself Medical Outcomes Profile (MYMOP). The transitional PROM was the Patient Enablement Instrument (PEI). Twenty patients who had recently attended the GP were interviewed while completing the questionnaires. Interview data was analysed using a modification of Tourangeau’s model of cognitive processing: comprehension, response, recall and face validity.ResultsPatients found the PEI simple to complete, but for some it lacked face validity. The transitional scale was sometimes confused with a status scale and was problematic in situations when the relevant GP appointment was part of a longer episode of care. Some patients reported a high enablement score despite verbally reporting low enablement but high regard for their GP, which suggested hypothesis-guessing. The interpretation of the PEI items was inconsistent between patients.MYMOP was more difficult for patients to complete, but had greater face validity than the PEI. The scale used was open to response-shift: some patients suggested they would recalibrate their definition of the scale endpoints as their illness and expectations changed.ConclusionsThe study provides information for both users of PEI/MYMOP and developers of individualised and transitional questionnaires.Users should heed the recommendation that MYMOP should be interview-administered, and this is likely to apply to other individualised scales. The PEI is open to hypothesis-guessing and may lack face-validity for a longer episode of care (e.g. in patients with chronic conditions). Developers should be cognisant that transitional scales can be inconsistently completed: some patients forget during completion that they are measuring change from baseline. Although generic questionnaires require the content to be more general than do disease-specific questionnaires, developers should avoid questions which allow broad and varied interpretations.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0850-2) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study

2018

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“…Other publications [23,24,25,26] have reported positive associations between lifestyle factors and use of CM/CAM/CIM.…”

Section: Lifestyles and Complementary Medicinementioning

confidence: 95%

Lifestyles and Complementary Medicine: A Survey in the Region of Tuscany

Stefano¹,

Baccetti²,

Rossi³

et al. 2018

obm icm

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Background: According to the international literature, users of Complementary Medicine (CM), Complementary and Alternative Medicine (CAM) and Complementary and Integrative Medicine (CIM) are physically more active, less overweight and have healthier lifestyles than the average Tuscan population. Aim: To evaluate the socio-demographic characteristics and lifestyles of patients of CM public clinics in the region of Tuscany and to define their profiles in terms of physical

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“…22 Alternatively, the Measure Yourself Medical Outcome Profile (MYMOP) was, among others, used in data collection projects in the United Kingdom (including MYMOP2 for long-term conditions), China and Germany (MYMOP-D). [23][24][25][26] The MYMOP measures change in intensity of both main problem and general health. The patients assess their situation over 'the last week'.…”

Section: Patient-reported Outcome Measuresmentioning

confidence: 99%

Electronic Registration in Complementary/Homeopathic Medical Practice with Identification of ‘Best Homeopathic Cases’: A Pilot Study

Klein-Laansma

Rutten

Fruijtier³

et al. 2018

Homeopathy

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Background Practice-based registration could identify ‘general’ and ‘homeopathic’ prognostic factors for therapeutic success in patients who seek complementary and alternative medicine (CAM)/homeopathic treatment. Identification of ‘best homeopathic cases’ within a database could inform clinical research and improve homeopathic practice. Objective To investigate the feasibility of registration in daily CAM/homeopathic practice, evaluate patient-reported outcome measures and tools for identifying ‘best homeopathic cases’ and to make recommendations for an electronic database. Methods In 2015 and 2016, 25 homeopathic doctors registered details of a maximum of 20 patients each, with 6 months of follow-up (extended follow-up for ‘best homeopathic cases’), in Excel or in the Homeopathic Administration and Registration Program (HARP) database. Informed consent was obtained from each patient. Patient-perceived change of main complaint was measured by a 7-point Likert scale. Best homeopathic cases were defined by treatment with one homeopathic medicine, ≥ 2 months of follow-up, result score +2 to +4 on a 9-point Likert scale by the doctor, and by changes that could be attributed to the homeopathic medicine. Association between scores for change of main complaint and scores for ‘best homeopathic case’ was analysed by the Kruskal gamma test. Results Three-hundred and ninety-nine patients were included. In 49.1%, the main complaint was present for ≥ 2 years. The most common diagnosis was ‘fatigue’ (N = 56; 14%). Major improvement in the main complaint (score +3) was reported by 22 to 26% at consecutive follow-up visits. One-hundred and ninety-six patients were treated with a single homeopathic medicine, among whom 66 ‘best homeopathic cases’ were identified. The correlation between patient-reported changes of main complaint and assessment by the doctor was significant (gamma = 0.832; p < 0.001). Conclusions Registration of (co-)diagnoses, chronicity, treatments and outcomes in homeopathic practice with identification of ‘best homeopathic cases’ is feasible, using the tools provided. A user-friendly electronic database for efficient recording is recommended.

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Complementary and alternative medicine (CAM) as part of primary health care in Germany–comparison of patients consulting general practitioners and CAM practitioners: a cross-sectional study

Cited by 22 publications

References 22 publications

Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study

Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study

Lifestyles and Complementary Medicine: A Survey in the Region of Tuscany

Electronic Registration in Complementary/Homeopathic Medical Practice with Identification of ‘Best Homeopathic Cases’: A Pilot Study

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