Homoeopathic association of South Africa The BHF Southern African Conference 22-25 July’07 Sun...

Homoeopathicassociation ofSouth Africa The BHF Southern African Conference 22-25 July’07 Sun City

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Homoeopathy as an Example

Dr. Neil Gower M.Tech Hom (UJ)

HSA National Secretary

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Complementary Medicine in a Basic Benefit Package


CAM Professions

• As regulated through the Allied Health Professions Act, 1982 (Act 63 of 1982):– PBHNP – Homoeopathy, Naturopathy,

Phytotherapy– PBCO – Chiropractic, Osteopathy– PBAUC – Ayurveda, Unani Tibb,

Chinese Medicine and Acupuncture– PBARM – Therapeutic: Aromatherapy,

Reflexology, Massage Therapy

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Basic Benefit Package

DEFINE:• What are we trying to achieve?• What needs are we trying to satisfy?

– common basic benefit for all South Africans

– Bearing in mind right to choose and access to healthcare

– Treatment, maintenance AND prevention– Support Health maintenance / chase our

tails? SYSTEMS• Essentially: primary healthcare?

– Established patients of homoeopathy use it for this purpose

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Homoeopathy

Two definitions:• Homoeopathy: a comprehensive

system of treatment based on the principle of likes cure likes.

• Homoeopathy in SA:Inclusive of the use of a variety of medicinal options and applications fulfilling a role of primary contact physician

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Homoeopathic Training

• South Africa:– M.Tech Hom – only degree

permitting registration (since 2000)

– 5 year Masters degree– University of Johannesburg and

Durban University of Technology– Aimed at preparing a practitioner

for a role in primary healthcare as a first contact and fulfilling the prescribed scope of practice

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Scope of Practice

• Allied Health Professions Act, 1982 (Act 63 of 1982):– Section 1 (2): (a) a practitioner may-

(i) diagnose, and treat or prevent, physical and mental disease, illness or deficiencies in humans;

(ii) prescribe or dispense medicine; or(iii) provide or prescribe treatment for such

disease, illness or deficiencies in humans;

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Scope of Practice (Cont…)

• Allied Health Professions Act, 1982 (Act 63 of 1982):– Reg. 28:Subject to the provisions of the Medicines and

Related Substances Control Act, 1965, a practitioner registered as a homeopath may, for the purposes of his or her practice‑

(a) possess or have under his or her control-(b) prescribe for a patient or supply to a patient-(c) formulate, compound, prepare, manipulate or

dispense-

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• Allied Health Professions Act, 1982 (Act 63 of 1982):– Reg. 28:Crude substancesHomoeopathic substances (any &

all)Vitamins, minerals, supplementsInjectable forms thereof

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• Allied Health Professions Act, 1982 (Act 63 of 1982):– Reg. 47:The following acts are acts specially pertaining to

the profession of a homeopath:(a) The physical examination of any person,

taking into account the totality of symptoms and the modalities and peculiarities thereof, for the purpose of diagnosing any physical defect, illness or deficiency in such person.

(b) The treatment or prevention of any physical defect, illness or deficiency in any person by remedies, dietary advice or dietary supplementation in accordance with and based on homeopathic principles.

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Homoeopathy?

• What does it have to offer?– Comprehensive system that

requires a comprehensive analysis– Profound understanding of disease

prevention, pathology and its progression

– Offers a viable “alternative” for:• Acute conditions• Chronic conditions

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Homoeopathy? (Cont…)

• Misunderstandings:– “Natural”– Ethereal, mystic– Severely limited:

• Sinusitis• Eczema• Allergies• Immune boosting

– Safe, easy - picked up from a book

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Yet at same time “last hope” and “miracle workers” for so many.



• In fact:– Healing mechanism assists natural

healing processes iatrogenic effects and persistent side effects are not present. Homoeopathic aggravations can occur but under professional guidance are part of the “healing crisis”

– Comprehensive system and methodology through precise symptomatology and prescribing

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• In fact (cont…):– Every condition is treated – limitations are

by way of medical logic: surgical need, end-stage disease, “obstacles to cure”:

• Infectious diseases, Hormonal imbalances, Pain, Dermatological conditions, Neurological complaints, Cardio-vascular, Respiratory, Arthritis, Blood pressure, Diabetes,, ADHD, Depression, SLE, Hepatitis, Cancer and Aids.

– Due to its nature requires continuous education, reading: pathology, diagnosis, medicine, pharmacology, homoeopathy, prescription, compounding, dispensing, other CAMs

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Evidence

• American Journal of Pain Management Osteoarthritic Pain: A Comparison of Homeopathy and Acetaminophen

The investigators conclude that homeopathic treatments for pain in OA patients appear to be safe and at least as effective as acetaminophen, and are without its potential adverse effects including compromise to both liver and kidney function.

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Shealy et al.; American Journal of Pain Management; 1998;8:89-91; Osteoarthritic Pain: A Comparison of Homeopathy and Acetaminophen


Evidence (Cont…)

• British Medical JournalEffect of Homoeopathic Treatment on Fibrositis

It showed a significant reduction in tender spots, by 25%, when patients were given the homeopathic medicine, as compared to when they were given the placebo.

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Fisher et al.; British Medical Journal; Effect of Homoeopathic Treatment on Fibrositis; August 5, 1989, 299:365-66.


Evidence (Cont…)

• CHESTInfluence of (homoeopathic) potassium dichromate on tracheal secretions in critically ill patients

CONCLUSION: These data suggest that potentised (diluted and vigorously shaken) potassium dichromate may help to decrease the amount of stringy tracheal secretions in COPD patients.

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M. Frass et al. CHEST, March, 2005; Influence of (homoeopathic) potassium dichromate on tracheal secretions in critically ill patients


Evidence (Cont…)

• BMC Complementary & Alternative MedHomeopathic and conventional treatment for acute respiratory and ear complaints: a comparative study on outcome in the primary care setting. CONCLUSION: In primary care, homeopathic treatment for acute respiratory and ear complaints was not inferior to conventional treatment. [Ed.: faster improvement in first 7 days; no adverse drug reactions for adult group]

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M. Haidvogl et al. BMC Complement Altern Med. 2007 Mar 2;7:7 Homeopathic and conventional treatment for acute respiratory and ear complaints: a comparative study on outcome in the primary care setting.


Evidence (Cont…)

• Explore (NY) Efficacy of a complex homeopathic medication (Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial

CONCLUSION: This complex homeopathic medication is safe and appears to be an effective treatment for acute maxillary sinusitis.

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DI Zabolotnyi et al.; Explore (NY) 2007 Mar-Apr;3(2):98-109.; Efficacy of a complex homeopathic medication (Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial.


Evidence (Cont…)

• Complementary Therapies in Medicine

Homoeopathy in primary care: self-reported change in health status.

1 year after first examination 73.5% of patients reported a marked or moderate improvement in their health status.

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F. Attena et al. Complement Ther Med. 2000 Mar;8(1):21-5. Homoeopathy in primary care: self-reported change in health status.


Evidence (Cont…)

• Biomedical Therapy Acute Otitis Media in Children: A Comparison of Conventional and Homeopathic Treatment

They found that the total recurrences of the homeopathic treated group was .41 per patient, while the antibiotic treatment group was .70 per patient. Of the "homeopathic" children who did have another earache, 29.3% had a maximum of three recurrences, while 43.5% of the "antibiotic" children had a maximum of six recurrences.

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KH Friese et al.; Biomedical Therapy, 60,4,1997:113-116; Acute Otitis Media in Children: A Comparison of Conventional and Homeopathic Treatment


Evidence (Cont…)

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• British Homeopathic Journal Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution?

Pain control was achieved in 39% of the patients after 6 h, another 33% after 12 h. This resolution rate is 2.4 times faster than in placebo controls. There were no complications observed in the study group, and compared to conventional treatment the approach was 14% cheaper.

H. Frei et al.; Br Homeopath J. 2001 Oct;90(4):180-2; Homeopathy in acute otitis media in

children: treatment effect or spontaneous resolution?


Evidence (Cont…)

• Homeopathy Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children

Homeopathy may be a cost-effective alternative to antibiotics in the treatment of recurrent infantile rhinopharyngitis

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M. Trichard et al.; Homeopathy. 2005 Jan;94(1):3-9; Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children


Evidence (Cont…)

• Homeopathy Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit.

On day 180, survival was statistically significantly higher with verum homeopathy (75.8% vs 50.0%, P = 0.043). CONCLUSION: Our data suggest that homeopathic treatment may be a useful additional therapeutic measure with a long-term benefit for severely septic patients admitted to the intensive care unit.

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M. Frass et al.; Homeopathy. 2005 Apr;94(2):75-80; Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit


Evidence (Cont…)

• European Journal of Pediatric SurgeryHomeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial CONCLUSION: The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder, particularly in the areas of behavioural and cognitive functions.

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H. Frei et al.; Eur J Pediatr. 2005 Dec 164(12):758-67; Epub 2005 Jul 27; Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial


Examples

• The WHO noted in 19941 that homeopathy had been integrated into the national health care systems of numerous countries, including:– Germany– United Kingdom– India - AYUSH– Pakistan– Sri Lanka– Mexico

Poitevin, B. "Integrating Homoeopathy in Health Systems." Bulletin of the World Health Organization. 1999. 77(2):160-6

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Examples (cont…)

• France– Homoeopathic treatment reimbursed by

French social security system• United Kingdom*

– Homoeopathic treatment reimbursed and part of National Health System

• Brazil– Homoeopathy – recognised speciality by

medical authorities since 1992 – forms part of public and community health programmes

Poitevin, B. "Integrating Homoeopathy in Health Systems." Bulletin of the World Health Organization. 1999. 77(2):160-6

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Basic Benefit Package

• Primary Healthcare:– First contact

• Base Referral System with a recognition of limitations (through education)

– Comprehensive– Systematic– Trusted– Prevention – HEALTH based,

individualised

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Sir William Osler, Father of Modern Medicine (1849 – 1919):

“The individual, not the disease, is the entity.”

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Homoeopathic association of South Africa The BHF Southern African Conference 22-25 July’07 Sun...

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