title: Anthroposophic therapies in chronic disease: the Anthroposophic Medicine Outcomes Study (AMOS).
abstract: BACKGROUND
  Anthroposophic medicine (AM) is used worldwide for chronic diseases.
  
  
  OBJECTIVE
  To study clinical outcomes and costs in patients treated with AM therapies for chronic conditions.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  141 medical practices in Germany providing AM treatment.
  
  
  METHODS
  898 outpatients aged 1-75 years referred to AM therapies (art, eurythmy or rhythmical massage, n = 665) or starting AM medical treatment (counselling, medicines, n = 233).
  
  
  METHODS
  Disease severity assessed independently by physician (Disease Score) and patient (Symptom Score), and health-related quality of life (SF-36, KINDL, KITA) after 3, 6, 12, 18, and 24 months; health costs in pre-study year and first study year.
  
  
  RESULTS
  Most common indications were mental disorders (32.0%), and musculoskeletal disorders (18.9%). Disease duration at baseline was median 3.0 years (interquartile range = i.q.r. 1.0-8.5, mean 6.5 +/- 8.4 years). Median number of AM therapy sessions was 12 (i.q.r. 10-20), median therapy duration was 120 days (i.q.r. 81-195). From baseline to 6-month follow-up, Disease Score (0-10) improved from 6.40 +/- 1.76 to 3.43 +/- 2.23 (p < 0.001), Symptom Score (0-10) improved from 5.89 +/- 1.75 to 3.35 +/- 2.09 (p < 0.001). In adults, SF-36 Physical Component Summary improved from mean 43.34 +/- 10.58 at baseline to 47.44 +/- 10.32 after 6 months (p < 0.001), SF-36 Mental Component Summary improved from 38.83 +/- 12.45 to 44.93 +/- 10.92 (p < 0.001). Similar HRQoL improvements were observed in children (KINDL, KITA). All improvements remained stable until 24-month follow-up. Adverse effects from AM therapies occurred in 2.7% (19/712) of patients. Three (0.5%) patients stopped therapy due to adverse effects. Health costs were 3,637 Euro per patient in the pre-study year and 3,484 Euro in the first study year, a decrease of 152 Euro (4.2%) per patient.
  
  
  CONCLUSIONS
  Anthroposophic therapies were associated with long-term reduction of chronic disease symptoms, improvement of health-related quality of life, and health cost reduction.
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, Freiburg/Bad Krozingen, Germany. harald.hamre@ifaemm.de
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hamre
authors.forename: C
authors.initials: C
authors.lastname: Becker-Witt
authors.forename: A
authors.initials: A
authors.lastname: Glockmann
authors.forename: R
authors.initials: R
authors.lastname: Ziegler
authors.forename: S N
authors.initials: SN
authors.lastname: Willich
authors.forename: H
authors.initials: H
authors.lastname: Kiene
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy*; D015331:Cohort Studies; D000529:Complementary Therapies; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007223:Infant; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome