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Research: HULME and LONG,
Listed in Issue 116
Abstract
HULME and LONG, Health Care Practice R&D Unit, University of Salford, Frederick Road Campus, UK, c.t.hulme@salford.ac.uk, have reviewed (51 references) economic evaluation of complementary and alternative medicine.
Background
As knowledge of the safety and effectiveness of complementary and alternative medicine interventions increases, economic evaluation within CAM has a heightened significance for decision making processes in health care. The aim of this study was to explore whether the present framework of economic evaluation fits CAM and what modifications might be needed.
Methodology
A comprehensive search of databases was carried out. Studies that contained a comparison of cost between a CAM discipline and conventional treatment were included in this systematic review.
Results
A total of 19 studies was found, of which 17 compared a CAM treatment used alongside conventional treatment. The majority of the studies aimed to relieve pain. Only a small minority of studies measured other health parameters which might be relevant in CAM treatments. 9 studies calculated only the cost to the service provider, and 7 included sickness absence costs. Only one study considered cost to relatives.
Conclusion
A CAM sensitive approach to economic evaluation is required. This needs to include a focus on outcomes that explore the range of effects of CAM treatment, an exploration of the client's perspective (not just that of the service provider) and study designs that facilitate the individualized practitioner approach so central to CAM treatment.
References
Hulme C, Long AF. Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine. Journal of Alternative & Complementary Medicine 11 (1): 179-188, Feb 2005.
Comment
The above two studies demonstrate that there is a significant body of published scientific literature in the fields of complementary and alternative medicine, (>20,000 published studies from 1997-2002). However, because these studies are either published in journals that are not the most influential to medical and scientific professionals, or they are not comprised of randomized controlled trials, this research is not having the impact deserved upon the weight of the research output (0.7% of all Medline papers published). This reflects important issues regarding the nature of research and its publication, not to mention the impact upon the greater public health.
