Effectiveness, Quality of Life, and Cost of Caring for Children in France with Recurrent Acute Rhinopharyngitis Managed by Homeopathic or Non-Homeopathic General Practitioners A Pragmatic, Prospective Observational Study

摘要

Background & Objective: In France, non-homeopathic general practitioners (GPs) often use antibacterials to treat children with recurrent acute viral rhinopharyngitis; whereas homeopathic GPs tend to use homeopathic medicines. We compared the effectiveness, the quality of life of the parents, and the direct and indirect costs associated with treatment from homeopathic and non-homeopathic GPs.Method: We assessed the direct (consultations, medicines, further tests) and indirect (time off work) costs of the two types of treatment to society, the patient, and social security. We also assessed the effectiveness of the treatment received and the quality of life of the parents.Results: Of the 499 children included, 231 were treated by 62 non-homeopathic GPs and 268 by 73 homeopathic GPs. The effectiveness (assessed as complications/patient, total number of adverse events, and quality of life) [mean overall Parents of children with Ear, Nose, and Throat infections Quality of Life questionnaire~C scale score] was better in the homeopathic GP group than in the non-homeopathic GP group. No significant difference was found between the two groups for the total costs to social security (implied by98.55 for homeopathic GPs vs implied by96.17 for non-homeopathic GPs). Homeopathic GPs initiated preventive treatment in 82.2% of their patients and used antibacterials in 20.9% of their patients, while non-homeopathic GPs initiated preventive treatment in 43.3% of patients and prescribed antibacterials for 89.6% of patients.Conclusion: This study produced new findings that indicate that, in France, acute rhinopharyngitis is handled differently by homeopathic GPs and non-homeopathic GPs: homeopathic GPs prescribe fewer antibacterials than non-homeopathic GPs for the treatment of recurrent acute rhinopharyngitis in children aged between 18 months and 4 years. Moreover, homeopathic treatment gave better results in terms of pragmatic medical effectiveness (fewer episodes and fewer complications) and the parents' quality of life, with similar total medical costs to social security. However, this study is potentially biased by the lack of homogeneity of the two patient-samples in terms of the 'passive smoking', 'patient age', 'childcare', and 'type of occupation' criteria because our study protocol did not provide for prior matching of the two patient-samples with respect to these criteria. The observations found in this study need to be confirmed by randomized clinical trials.