title: Comparative effectiveness of homoeopathic vs. conventional therapy in usual care of atopic eczema in children: long-term medical and economic outcomes.
abstract: BACKGROUND
  One in five children visiting a homeopathic physician suffers from atopic eczema.
  
  
  OBJECTIVE
  We aimed to examine the long-term effectiveness, safety and costs of homoeopathic vs. conventional treatment in usual medical care of children with atopic eczema.
  
  
  METHODS
  In this prospective multi-centre comparative observational non-randomized rater-blinded study, 135 children (48 homoeopathy, 87 conventional) with mild to moderate atopic eczema were included by their respective physicians. Depending on the specialisation of the physician, the primary treatment was either standard conventional treatment or individualized homeopathy as delivered in routine medical care. The main outcome was the SCORAD (SCORing Atopic Dermatitis) at 36 months by a blinded rater. Further outcomes included quality of life, conventional medicine consumption, safety and disease related costs at six, 12 and 36 months after baseline. A multilevel ANCOVA was used, with physician as random effect and the following fixed effects: age, gender, baseline value, severity score, social class and parents' expectation.
  
  
  RESULTS
  The adjusted mean SCORAD showed no significant differences between the groups at 36 months (13.7 95% CI [7.9-19.5] vs. 14.9 [10.4-19.4], p = 0.741). The SCORAD response rates at 36 months were similar in both groups (33% response: homoeopathic 63.9% vs. conventional 64.5%, p = 0.94; 50% response: 52.0% vs. 52.3%, p = 0.974). Total costs were higher in the homoeopathic versus the conventional group (months 31-36 200.54 Euro [132.33-268.76] vs. 68.86 Euro [9.13-128.58], p = 0.005).
  
  
  CONCLUSIONS
  Taking patient preferences into account, while being unable to rule out residual confounding, in this long-term observational study, the effects of homoeopathic treatment were not superior to conventional treatment for children with mild to moderate atopic eczema, but involved higher costs.
authors: Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Centre, Berlin, Germany.
authors: Stephanie
authors: S
authors: Roll
authors: Thomas
authors: T
authors: Reinhold
authors: Daniel
authors: D
authors: Pach
authors: Benno
authors: B
authors: Brinkhaus
authors: Katja
authors: K
authors: Icke
authors: Doris
authors: D
authors: Staab
authors: Tanja
authors: T
authors: Jäckel
authors: Karl
authors: K
authors: Wegscheider
authors: Stefan N
authors: SN
authors: Willich
authors: Claudia M
authors: CM
authors: Witt
mesh_terms: D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006705:Homeopathy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D006801:Humans; D008297:Male; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome
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