title: Effects and feasibility of an Integrative Medicine program for geriatric patients-a cluster-randomized pilot study.
abstract: BACKGROUND
  Older adults often use complementary medicine; however, very few interventional studies have focused on them. The aim of this study was to evaluate the feasibility and to obtain preliminary data on effectiveness of an Integrative Medicine (IM) program compared to usual medical care.
  
  
  METHODS
  The study consisted of older adults living in shared apartment communities including caregiving. The shared apartments were cluster-randomized to the IM program or Usual Care (UC). IM consisted of additional lifestyle modification (exercise and diet), external naturopathic applications, homeopathic treatment, and modification of conventional drug therapy for 12 months. The UC group received conventional care alone. The following outcomes were used: Nurses Observation Scale for Geriatric Patients (NOSGER); Assessment of Motor and Process Skills; Barthel Index; Qualidem; Profile of Wellbeing; and Mini-mental State Examination. Exploratory effect sizes (Cohen's d, means adjusted for differences of baseline values) were calculated to analyze group differences.
  
  
  RESULTS
  A total of eight shared apartment communities were included; four were allocated to IM (29 patients, median seven patients; [mean ± standard deviation] 82.7 ± 8.6 years) and four to UC (29 patients, median eight patients; 76.0 ± 12.8 years of age). After 12 months, effect sizes ≥0.3 were observed for activities of daily living on the NOSGER-Activities of Daily Living subscale (0.53), Barthel Index (0.30), Qualidem total sum score (0.39), Profile of Wellbeing (0.36), NOSGER-Impaired Social Behavior (0.47), and NOSGER-Depressed Mood subscales (0.40). Smaller or no effects were observed for all other outcomes. The intervention itself was found to be feasible, but elaborate and time consuming.
  
  
  CONCLUSIONS
  This exploratory pilot study showed that for a full-scale trial, the outcomes of Activities of Daily Living and Quality of Life seem to be the most promising. The results have to be interpreted with care; larger confirmatory trials are necessary to validate the effects.
authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany. michael.teut@charite.de
authors.forename: Michael
authors.initials: M
authors.lastname: Teut
authors.forename: Katharina
authors.initials: K
authors.lastname: Schnabel
authors.forename: Roland
authors.initials: R
authors.lastname: Baur
authors.forename: Annette
authors.initials: A
authors.lastname: Kerckhoff
authors.forename: Frauke
authors.initials: F
authors.lastname: Reese
authors.forename: Niels
authors.initials: N
authors.lastname: Pilgram
authors.forename: Franziska
authors.initials: F
authors.lastname: Berger
authors.forename: Rainer
authors.initials: R
authors.lastname: Luedtke
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Witt
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D016000:Cluster Analysis; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Activities of Daily Living; NOSGER; apartment-sharing communities; caregiving; complementary and alternative medicine strategies; homeopathy; older adults
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