[Omeo33] Art 1139 - Homeopathy, 2010, 99 (3), 192-204

[Gino Santini]

Semi-standardised homeopathic treatment of premenstrual syndrome with  
a limited number of medicines: Feasibility study
C.T. Klein-Laansma, J.C.H. Jansen, A.J.W. van Tilborgh, D.A.W.M. Van  
der Windt, R.T. Mathie and A.L.B. Rutten

Background - Individualised homeopathy involves a large number of  
possible medicines. For clinical research purposes it is desirable to  
limit this number, create more consistency between prescribers and  
optimising the accuracy of prescription. Using a semi-standardised  
treatment protocol, we aimed to improve homeopathic management of  
targeted subgroups of women with premenstrual syndrome/symptoms (PMS/S).
Objective - To design a semi-standardised protocol for individualised  
prescribing in PMS/S with a limited number of homeopathic medicines,  
and to explore the feasibility of working with it in daily homeopathic  
practice.
Methods - With help of an expert panel, homeopathic medicines were  
selected, as well as predictive symptoms and characteristics  
(keynotes) for each medicine. With those, we designed a patient  
questionnaire and a diagnostic algorithm. The patient questionnaire  
contained 123 questions, representing potential predictive symptoms  
for 11 homeopathic medicines for PMS/S. The medicines selected (in  
rank order) were Sep, Nat-m, Lach, Cimic, Lac-c, Puls, Calc, Lil-t,  
Mag-p, Mag-c, Phos. In a feasibility study 20 homeopathic doctors used  
the protocol in daily practice. The diagnosis was confirmed by daily  
rating of pre-defined symptoms during two consecutive menstrual  
cycles. The acceptability and feasibility of the protocol were  
evaluated after 3 months follow-up, at which time we also measured  
changes in premenstrual symptom scores and patient-reported changes in  
symptoms and general health.
Results - The doctors mostly complied with the protocol and valued the  
computerised diagnostic algorithm as a useful tool for homeopathic  
medicine selection. 33 patients completed 3 months follow-up. By then,  
19 patients still taking the first medicine on the basis of the  
algorithm. We received valid symptom records of 30 patients.  
Premenstrual symptom scores dropped by 50% or more in 12 patients and  
by 30–50% in 6 patients; scores dropped by less than 30% or increased  
in 12 patients. Recruitment of patients (n = 38 in 9 months) proved  
difficult. Adherence to the diaries and the questionnaire was  
satisfactory.
Conclusions - It is feasible to use a semi-standardised protocol for  
individualised homeopathic prescribing in PMS, in daily practice. Its  
predictive value and the percentage of women with PMS/S helped by the  
selected medicines remain to be evaluated in further research. In  
future research, active promotion will be needed to recruit patients.

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