title: A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice.
abstract: Homeopathic medicines are regarded as safe but practitioners report several types of healing or remedy reactions including aggravations, new symptoms and recurrence of old symptoms, some of which could be regarded as side effects or unwanted effects. Some remedy reactions may be regarded as adverse events. AUDIT QUESTIONS: Do such reactions occur within our unit, and if so, how frequently? Do patients regard these events as "adverse"?
  
  
  METHODS
  The audit was carried out in the Bristol Homeopathic Hospital Outpatient Department. All patients were given a questionnaire to complete when at their first follow-up consultation approx 6-10 weeks after their first appointment. One hundred and sixteen patients were sampled over a 2-month period.
  
  
  RESULTS
  Reactions were frequent: 28 out of the 116 (24%) patients, experienced an aggravation. Thirteen patients (11%) reported an adverse event even though 5 of those were patients who also reported an aggravation followed by an overall improvement of their symptoms. Thirty-one patients described new symptoms (27%) and 21(18%), a return of old symptoms. Those experiencing the latter appeared to have better outcomes.
  
  
  CONCLUSIONS
  Remedy reactions are common in clinical practice; some patients experience them as adverse events. Systematically recording side effects would facilitate our understanding of these reactions and would enable standards to be set for audit of information and patient care.
authors.affiliation: Bristol Homeopathic Hospital, United Bristol Healthcare Trust, Cotham Hill, Bristol BS6 6PD, UK. elizabeth.thompson@ubht.swest.nhs.uk
authors.forename: E
authors.initials: E
authors.lastname: Thompson
authors.forename: S
authors.initials: S
authors.lastname: Barron
authors.forename: D
authors.initials: D
authors.lastname: Spence
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006705:Homeopathy / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008419:Materia Medica / Q000009:adverse effects* / Q000592:standards; D008485:Medical Audit; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom
chemical_list: D008419:Materia Medica