Using a computer-based clinical management system to improve effectiveness of a homeopathic service in a fundholding general practice.
Problems which the development attempts to address. This study's overall objectives were to determine whether: * The aims of collaboration between General Practitioner (GPs) and a homeopath can be made explicit and service delivery optimised by using computer-based data collection in a multi-disciplinary primary care team that includes a homeopathic practitioner. * Outcomes of the homeopathic service can be evaluated in a practical way, which allows quality assurance through rapid audit cycles.


METHODS
The primary care team (PCT) explored the problems of developing a rational and quality assured complementary therapy service in a series of meetings in an NHS practice where complementary therapists are members of the PCT. This led to the defining of data-collection structures and processes needed. The researchers designed and supervised their implementation and evaluation through a series of action research cycles. A database was designed which allowed the clinicians to track interventions and outcomes using the Measure Your Own Medical Outcome Profile (MYMOP). Critical incidents were brought to fortnightly clinical meetings and methods were continually adapted as problems arose and new options emerged at six-weekly audit meetings.


RESULTS
GPs tended to refer patients who do not fit easily into biomedical disease categories. Patients referred tend to self-rate themselves as experiencing notably poor wellbeing. MYMOP has to be used skillfully with homeopathic patients, especially where psychological distress is identified as one of their main complaints.


CONCLUSIONS
It is possible to introduce rigour and reflectiveness when providing a homeopathic service in general practice by assessing the needs of patient and practitioners, agreeing intake guidelines, developing referral processes, implementing audit cycles. Clear lines of communication can be established and a patient-centred outcome measure can be introduced into the treatment cycle.
Marylebone Health Centre, University of Westminster, London, UK. petersd@umin.ac.uk
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D003628:Database Management Systems; D005194:Family Practice / Q000458:organization & administration* / Q000592:standards; D006705:Homeopathy / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008131:London; D017063:Outcome Assessment, Health Care; D011216:Practice Management, Medical / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*