Homeopathic Medicine Should Have a Role in Mis-Managed Care

Homeopathic Medicine Should Have a Role in Mis-Managed Care

I ran across Homeopathic Medicine Should Have a Role in Managed Care over at managedcaremag.com. The article is by a PhD from the Temple University School of Pharmacy.

Seeing an article by not only pharmacist, but a professor and a dean suggesting homeopathy gives me pause.

It is like a dean of astronomy suggesting astrology or a professor of chemistry suggesting alchemy. On the other hand, perhaps I have missed something in all my years of participating in science-based medicine. Perhaps he offers a hitherto unrecognized reason that literally nothing is an appropriate and ethical intervention for patients.

Nope.

Just the usual tropes long since debunked here and SBM. Just as pseudo-medicines never change because of evidence, neither do the fallacious augments in their favor. As I say, there is a reason that we have Sisyphus as our logo.

The author starts with mentioning homeopathy is old and popular. Like narcotics, I suppose.  So lets loosen up the restrictions on oxycontin.  Many patients would love that as well. 

He freqently notes many of reasons homeopathy should not be used

Although research into homeopathic treatments is on the rise, their clinical utility in managing disease is questioned because of limited robust safety and efficacy studies.

and

Given that homeopathic treatments do not fall into any of these categories concisely, they remain relatively unregulated with regard to safety, efficacy, and value.

and

These agents are not required to show safety and efficacy data for approval for use in the United States.

Not exactly building a compelling reason for use of therapeutic intervention. Should a pharmaceutical with those recommendation show up on the agenda for my P&T committee, I would have a field day of derision.

He then discusses whether or not homeopathy is a placebo or has a real response. As if a professor of pharmacy would have any doubt. He cherry picks a few positive studies and counters with mentioning the Australian meta-analysis with the anemic

The council found that study designs limited the conclusions that could be drawn with regard to homeopathy demonstrating superior efficacy to placebo preparations.

The argument is, to my reading, a disingenuous discussion on the use of placebo and homeopathy that allow the author to conclude

Thus, the use of homeopathy and the potential for the placebo effect may play an important role in the management of difficult-to-treat patients who present with symptoms of unknown etiology. For example, a patient may present with a generalized sense of anxiety but not be a candidate for treatment with a traditional pharmacologic agent because of 1 or more mitigating factors. Such a patient could be prescribed a homeopathic treatment for anxiety. In such a situation, the patient may feel satisfied with the holistic treatment approach and also may experience the placebo effect manifesting as a reduction in anxiety.

He then notes homeopathy and CAM are popular in the US and is sold in pharmacies, as if popularity is a justification for defrauding patients  with useless therapies. He even quotes Dana Ulllman. I am surprised he didn't include Mercola or the Health Ranger as a reference.

Then the whopper:

At present, it looks as though we are faced with an all-too-frequent dilemma of having to make decisions with insufficient information.

Really?  Anyone who goes beyond a half-assed glance on the topic of homeopathy would realize we do not lack information on homeopathy. It is water. Homeopathy does nothing. Homeopathy can't do anything. Homeopathy is a fantastical farce.

So despite saying

Given the lack of safety, efficacy, and value data for homeopathic preparations,

and that there is

little solid evidence from which to inform policy, from the body of knowledge surrounding homeopathic preparations.

that P&T committee should add homeopathic preparations for

… when no organic source of some symptoms can be determined, the use of some nonspecific homeopathic agent might be considered when the patient clearly expects a medication prescription.

In other words, lie to the patient and waste managed care dollars on overpriced water in the hope that the patient will have a response.

It is not unlike the internist who suggested hiring naturopaths to take over the care of difficult patients: The unethical use of unethical and useless therapies.

It is sad.

Given the source, a professor and a dean of pharmacy, this has to be the worst and most muddled, confused and poorly researched articles justifying homeopathy I have ever read, and I have read some doozies.

The site says the articles are peer-reviewed. You know. Peer. To look at with difficulty. I am sure the reviewer peered over her bifocals. Yep, this 'peers to be an article about managed care. Publish it.

Points of Interest 07/22/2015
Points of Interest 07/18/2015

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