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Research: MOEBUS and co-workers,
Listed in Issue 137
Abstract
MOEBUS and co-workers, Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany, susanne.moebus@uni-essen.de, have studied the levels of sick leave in patients with chronic illness who receive CAM therapies.
Background
Little is known about the effects of CAM treatments in primary care, delivered by general practitioners within the health insurance system. From 1994 to 2000 more than 20 German Company health insurances initiated the first model project on CAM according to the German social law. The aim of this study was to investigate the effectiveness of multi-modal CAM on chronic diseases within primary health care.
Methodology
A long-term prospective intermittent study was conducted including 44 CAM practitioners and 1221 self-selected chronically ill patients (64% women), of whom 441 were employed. The main outcome measure was sick leave, controlled for secular trends and regression-to-the mean and self-perceived health status.
Results
Sick leave per year of 441 patients at work increased from 22 +/- 45.2 to 31 +/- 61.0 days within three years prior to intervention, and decreased to 24 +/- 55.6 in the second year of treatment, sustaining at this level in the following two years. Detailed statistical analysis showed that this development exceeded secular trends and the regression-toward-the-mean effect. Sick leave reduction was corroborated by data on self-reported improvement of patients’ health status.
Conclusion
The results of this long-term observational study show a reduction of sick leave in chronically ill patients after a complex multimodal CAM intervention. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, and provide information on the magnitude of the effects to facilitate subsequent definitive randomized controlled studies.
References
Moebus S, Lehmann N, Bodeker W, Jockel KH. An analysis of sickness absence in chronically ill patients receiving complementary and alternative medicine: a longterm prospective intermittent study. BMC Public Health 6:28, 2006.
