Anthroposophic vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study.
BACKGROUND
Acute respiratory and ear symptoms are frequently treated with antibiotics. Anthroposophic treatment of these symptoms relies primarily on anthroposophic medications.


OBJECTIVE
To compare anthroposophic treatment to conventional treatment of acute respiratory and ear symptoms regarding clinical outcome, medication use and safety, and patient satisfaction.


METHODS
Prospective, non-randomised comparison of outcomes in patients self-selected to anthroposophic or conventional therapy under real-world conditions.


METHODS
29 primary care practices in Austria, Germany, Netherlands, UK, and USA. PARTICIPANTS AND THERAPY: 1016 consecutive outpatients aged > or = 1 month, consulting an anthroposophic (n = 715 A-patients) or conventional physician (n = 301 C-patients) with a chief complaint of acute (< or = 7 days) sore throat, ear pain, sinus pain, runny nose or cough. Patients were treated according to the physician's discretion.


METHODS
Patients' self-report of treatment outcome (complete recovery/major improvement/slight to moderate improvement/no change/deterioration) at Day 14.


RESULTS
Most common chief complaints were cough (39.9% of A-patients vs. 33.9% of C-patients, p = 0.0772), sore throat (26.3% vs. 23.3%, p=0.3436), and ear pain (20.0% vs. 18.9%, p=0.7302). Baseline chief complaint severity was severe or very severe in 60.5% of A-patients and 53.3% of C-patients (p=0.0444), mean severity (0-4) of complaint-related symptoms was 1.3 +/- 0.7 vs. 1.2 +/- 0.6 (p=0.5197). During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 33.6% of C-patients (p<0.0001), anthroposophic medicines were prescribed to all A-patients and no C-patient.


RESULTS
Improvement within 24 hours occurred in 30.9% (221/715) of A-patients and 16.6% (50/301) of C-patients (p<0.0001), improvement within 3 days in 73.1% and 57.1% (p<0.0001). At Day 7 complete recovery or major improvement was reported by 77.1% of A-patients and 66.1% of C-patients (p=0.0004), at Day 14 by 89.7% and 84.4% (p=0.0198). Complete recovery rates at Day 7 were 30.5% and 23.3% (p<0.0001); at Day 14 they were 64.2% and 49.5% (p<0.0001). 69.9% of A-patients and 60.5% of C-patients were very satisfied with their physician (p=0.0043); 95.7% and 83.4% would choose the same therapy again for their chief complaint (p<0.0001). After adjustment for country, gender, age, chief complaint, duration of complaint, previous episode of complaint within last year, and baseline symptom severity, odds ratios favoured the A-group for all these outcomes. Adverse drug reactions were reported in 2.7% of A-patients and 6.0% of C-patients (p=0.0157).


CONCLUSIONS
Compared to conventional treatment, anthroposophic treatment of primary care patients with acute respiratory and ear symptoms had more favourable outcomes, lower antibiotic prescription rates, less adverse drug reactions, and higher patient satisfaction.
Hamre
Harald J
HJ
Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany. harald.hamre@ifaemm.de
Fischer
Michael
M
Heger
Marianne
M
Riley
David
D
Haidvogl
Max
M
Baars
Erik
E
Bristol
Eileen
E
Evans
Michael
M
Schwarz
Reinhard
R
Kiene
Helmut
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000887:Anthroposophy; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000628:therapy*; D017060:Patient Satisfaction; D010612:Pharyngitis / Q000628:therapy; D011320:Primary Health Care; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy; D013997:Time Factors; D014069:Tonsillitis / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents