Intrathecal baclofen and homeopathy for the treatment of painful muscle spasms associated with malignant spinal cord compression

Use of complementary and alternative medicine in persons with spinal cord injury in Switzerland: a survey study

STUDY DESIGN

Questionnaire-based survey study.

OBJECTIVES

To evaluate the use of and the satisfaction with complementary and alternative medicine (CAM) techniques in patients with spinal cord injury (SCI).

SETTING

Rehabilitation Center, Switzerland.

METHODS

Between May and September 2014, all patients with chronic (>1 year) SCI attending the urologic outpatient clinic were asked to fill in a questionnaire regarding the use of CAM.

RESULTS

Of the 103 participants (66 men and 37 women), 73.8% stated that they have used some form of CAM since SCI, with acupuncture and homeopathy being the two techniques that were used most frequently (31% each). The most common indications for CAM use were pain and urinary tract infections (UTIs). CAM was used supplementarily rather than exclusively. Overall satisfaction (85.1%) as well as satisfaction rates for the different indications (pain: 85%; UTI: 90.5%) and for the most frequently used forms of CAM (homeopathy: 90.6%; acupuncture: 78.1%) were high.

CONCLUSION

According to our data, there is a demand for adjunctive CAM procedures for the treatment of medical complications by persons with SCI. CAM led to high satisfaction levels. On the basis of these results, future research should systematically evaluate the therapeutic potential of the most popular CAM techniques, for example, acupuncture and homeopathy, for the treatment of secondary medical complications of SCI.

Can the caged bird sing? Reflections on the application of qualitative research methods to case study design in homeopathic medicine

BACKGROUND

Two main pathways exist for the development of knowledge in clinical homeopathy. These comprise clinical trials conducted primarily by university-based researchers and cases reports and homeopathic "provings" compiled by engaged homeopathic practitioners. In this paper the relative merits of these methods are examined and a middle way proposed. This consists of the "Formal Case Study" (FCS) in which qualitative methods are used to increase the rigour and sophistication with which homeopathic cases are studied. Before going into design issues this paper places the FCS in an historical and academic context and describes the relative merits of the method.

DISCUSSION

Like any research, the FCS should have a clear focus. This focus can be both "internal", grounded in the discourse of homeopathy and also encompass issues of wider appeal. A selection of possible "internal" and "external" research questions is introduced. Data generation should be from multiple sources to ensure adequate triangulation. This could include the recording and transcription of actual consultations. Analysis is built around existing theory, involves cross-case comparison and the search for deviant cases. The trustworthiness of conclusions is ensured by the application of concepts from qualitative research including triangulation, groundedness, respondent validation and reflexivity. Though homeopathic case studies have been reported in mainstream literature, none has used formal qualitative methods--though some such studies are in progress.

SUMMARY

This paper introduces the reader to a new strategy for homeopathic research. This strategy, termed the "formal case study", allows for a naturalistic enquiry into the players, processes and outcomes of homeopathic practice. Using ideas from qualitative research, it allows a rigorous approach to types of research question that cannot typically be addressed through clinical trials and numeric outcome studies. The FCS provides an opportunity for the practitioner-researcher to contribute to the evidence-base in homeopathy in a systematic fashion. The FCS can also be used to inform the design of clinical trials through holistic study of the "active ingredients" of the therapeutic process and its clinical outcomes.