Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study

Lamiae Grimaldi-Bensouda (1, 2) , Lucien Abenhaim (3, 4) , Jacques Massol , Didier Guillemot (5, 6) , Bernard Avouac (2) , Gerard Duru (7) , France Lert (8) , Anne-Marie Magnier (9) , Michel Rossignol (10) , Frederic Rouillon (11) , Bernard Begaud (12)

1 CNAM Paris - Centre d'enseignement Cnam Paris
2 LA-SER, Paris
3 LSHTM - London School of Hygiene and Tropical Medicine
4 LA-SER Europe Limited, London
5 IP - Institut Pasteur [Paris]
6 HUPO - Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest
7 Cyklad group
8 CESP - Centre de recherche en épidémiologie et santé des populations
9 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie
10 McGill University = Université McGill [Montréal, Canada]
11 Hôpital Sainte-Anne
12 Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations

Background: The purpose of the study was to compare utilization of conventional psychotropic drugs among patients seeking care for anxiety and depression disorders (ADDs) from general practitioners (GPs) who strictly prescribe conventional medicines (GP-CM), regularly prescribe homeopathy in a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho). Methods: This was one of three epidemiological cohort studies (EPI3) on general practice in France, which included GPs and their patients consulting for ADDs (scoring 9 or more in the Hospital Anxiety and Depression Scale, HADS). Information on all medication utilization was obtained by a standardised telephone interview at inclusion, 1, 3 and 12 months. Results: Of 1562 eligible patients consulting for ADDs, 710 (45.5 %) agreed to participate. Adjusted multivariate analyses showed that GP-Ho and GP-Mx patients were less likely to use psychotropic drugs over 12 months, with Odds ratio (OR) = 0.29; 95 % confidence interval (CI): 0.19 to 0.44, and OR = 0.62; 95 % CI: 0.41 to 0.94 respectively, compared to GP-CM patients. The rate of clinical improvement (HADS <9) was marginally superior for the GP-Ho group as compared to the GP-CM group (OR = 1.70; 95 % CI: 1.00 to 2.87), but not for the GP-Mx group (OR = 1.49; 95 % CI: 0.89 to 2.50). Conclusions: Patients with ADD, who chose to consult GPs prescribing homeopathy reported less use of psychotropic drugs, and were marginally more likely to experience clinical improvement, than patients managed with conventional care. Results may reflect differences in physicians' management and patients' preferences as well as statistical regression to the mean.

Mots clés: Anxiety; Depression; Homeopathy; Primary care

Domaines: Psychiatrie et santé mentale; Médicaments

Lamiae Grimaldi-Bensouda, Lucien Abenhaim, Jacques Massol, Didier Guillemot, Bernard Avouac, et al.. Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study. BMC Complementary and Alternative Medicine, 2016, 16, pp.125. ⟨10.1186/s12906-016-1104-2⟩. ⟨hal-01323761⟩