title: A comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care.
abstract: BACKGROUND
  Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care.
  
  
  OBJECTIVE
  To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM.
  
  
  METHODS
  This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness.
  
  
  METHODS
  All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment.
  
  
  METHODS
  The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample-t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores.
  
  
  RESULTS
  Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The proportion of subjects who had improvement in HRQOL scores were lower among subjects consulting the WM clinic (72.3%) than those consulting TCM clinics (100%) but the difference was not significant after correction for baseline scores.
  
  
  CONCLUSIONS
  Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong.
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong. wwong110@hkucc.hku.hk
authors.forename: Wendy
authors.initials: W
authors.lastname: Wong
authors.forename: L K Cindy
authors.initials: LK
authors.lastname: Lam
authors.forename: Rita
authors.initials: R
authors.lastname: Li
authors.forename: Sze Hon
authors.initials: SH
authors.lastname: Ho
authors.forename: Leung Kwok
authors.initials: LK
authors.lastname: Fai
authors.forename: Zhao
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008511:Medicine; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D019366:Western World