Anthroposophic Medicine. Effectiveness, utility, costs, safetyGunver Kienle MD*, Helmut Kiene MD*, Hans Ulrich Albonico, MD** *) Reviewers, Institute for Applied Epistemology and Medical Methodology IFAEMM, Schauinslandstrasse 6, DE-70189 Bad Krozingen. E-Mail: gunver.kienle@ifaemm.de, helmut.kiene@ifaemm.de   **) Expert for research in the field of anthroposophic medicine, Vereinigung Anthroposophisch Orientierter Ärzte in der Schweiz (VAOÄS), Bernstrasse 13, CH-3550 Langnau, E-Mail: albolem@hotmail.com ©2006 by Schattauer Verlag, Stuttgart-New York (Schattauer GmbH, Hölderlinstrasse3, DE-70174, Stuttgart, Germany). ISBN-10: 3-7945-2495-0 ISBN-13: 978-3-7945-2495-2

Content

• Introduction
• Presentation of the special aspects of anthroposophic medicine, in fundamental research and  clinical practice
• Discussion of the methodology
• Material and methods
• Results with regard to effectiveness, utility, costs and safety
• Discussion
• Comment on published criticism regarding studies with mistletoe
• Catalogue of case presentations and literature not used for the analysis etc.

Studies 

Single case studies (not analysed in the review): 2090 studies

Clinical studies suitable for analysis: 195 studies

Systematic reviews in 4 “Domains”: 127 studies

• Anthroposophic Medicine studied as a therapeutic system for various disorders (including comparisons of systems) 
  8 studies
• Treatment of pain or treatments of wounds with anthroposophic medicines 
  18 studies including 3 RCTs
• Non-pharmacologic treatment of various disorders 
  5 studies and 3 extra-analyses
• Anthroposophic mistletoe treatment of cancer
  96 studies including 15 RCTs

Further studies ("Appendix"): 68 studies

• Chronic hepatitis B or C 
  10 studies
• Neurological or psychiatric disorders 
  7 studies
• Gynaecology and Obstetrics 
  6 studies
• Acute infections (upper respiratory tract, ear, eyes, gastrointestinal) 
  18 studies
• Circulatory diseases 
  6 studies
• Thyroid diseases 
  4 studies
• Pulmonary diseases (sarcoidosis) 
  6 studies
• Other disorders 
  11 studies

Results: effectiveness

Results: summary 4 Domains and Appendix

195 studies were analysed:

186 studies had positive results for the AM-Group (similar or better result compared to conventional therapy regarding at least 1 clinical parameter).

• 8 studies showed neither positive nor negative results.
• 1 study showed a negative trend.
• The practical relevance was throughout the studies high.
• The quality of the studies varied from very to good to very poor (in particular the retrospective comparative studies).
• The satisfaction of the patients was high.
• The positive results were still relevant, if the analysis was restricted to the qualitatively good studies. 

Results: utility

Users of anthroposophic medicine:

• patients of basic national health care and patients with a special interest
• especially women, patients aged 30-50 years and children
• high level of education
• often after complications or ineffectiveness of conventional treatment
• interest in comprehensive treatment and active engagement
• high degree of patient-satisfaction with AM

Results: safety

• 2 carefully designed safety analyses, phase I-studies, questionnaires within the framework of clinical studies, database, case reports
• good compliance
• 0.005% of the applications of medicines caused slight side effects
• In general, AM had higher compliance and less side effects, if compared to conventional medicine.

Results: costs

• Within the framework of PEK the cost analysis was done in general and not differentiated for the different therapeutic approaches.
• Only very few cost analyses are available specifically for anthroposophic medicine.
• 1 German study, which was performed in 141 offices of anthroposophic medical doctors, including 898 patients treated with anthroposophic medicines for chronic diseases showed less costs during the study year, if compared to those during the year before enrolling into the study (3.484 Euro vs. 3.637 Euro).
• The patients treated with anthroposophic medicine had less costs for medicines and less referrals to hospital care, although the severity of their disorders was similar or even worse, if compared to the conventionally treated group.

Conclusions:

• Anthroposophic medical therapies result in favourable clinical outcomes according to the large majority of the reviewed studies. This conclusion also holds when limited to studies with good quality.
• Anthroposophic medicine is used by both patients within ordinary health care provision and by patients with a special interest for this therapeutic approach.
• Anthroposophic medical therapies are satisfactory to the patients and safe.

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