Practices with poor prescribing performance more likely to prescribe homeopathy
New research published today by the Journal of the Royal Society of Medicine finds that general practices in England with the worst prescribing quality scores are 2.1 times more likely to prescribe homeopathy than practices with the best prescribing quality scores.
Researchers from the University of Oxford and Exeter University looked at practices that prescribe homeopathy to see if they differ in their prescribing of other drugs. They found that even infrequent homeopathy prescribing is strongly associated with poor performance on a range of prescribing quality measures, but not with overall patient recommendation or quality outcomes framework score.
Lead researcher Dr Ben Goldacre, Senior Clinical Research Fellow at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: “Despite the lack of evidence for homeopathy, and its lack of a plausible mechanism, some NHS doctors still prescribe it. We set out to explore whether general practices prescribing homeopathic remedies also behave differently on other measures of general practitioner behaviour.”
The researchers identified 644 practices that had issued at least one homeopathy prescription in a six-month period (December 2016 to May 2017). There were 2,720 homeopathy prescriptions in total costing £36,532 (mean £13,43 per item).
They found that prescribing any homeopathy is associated with poorer performance at practice level on a range of standard prescribing measures. The association is unlikely to be a direct causal relationship, say the researchers, but may reflect deeper underlying practice features, such as the extent of respect for evidence-based practice, or poorer stewardship of the prescribing budget.
Dr Goldacre said: “Although NHS expenditure on homeopathy is low, we believe the strong association between homeopathy use and poorer prescribing in general is more important than cost. It should raise concerns and may be of interest to those seeking to understand variation in clinical styles and the use of alternative medicine by clinicians.”
Notes to editors
Is use of homeopathy associated with poor prescribing in English primary care? A cross-sectional study (DOI: 10.1177/0141076818765779) by Alex J Walker, Richard Croker, Seb Bacon, Edzard Ernst, Helen J Curtis and Ben Goldacre, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Thursday 19 April 2018.
The link to the full text version of the paper when published is: http://journals.sagepub.com/doi/full/10.1177/0141076818765779
For further information or a copy of the paper please contact:
Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44 (0) 1580 764713
M: +44 (0) 7785 182732
E: media@rsm.ac.uk
JRSM Open is a peer reviewed online-only journal that follows the open-access publishing model. It is a companion journal to the Journal of the Royal Society of Medicine and is published by Sage Publishing. JRSM Open publishes research papers, research letters, clinical reviews and case reports in any specialty and from any country. The aim of JRSM Open is to influence clinical practice and policy making across the whole range of medicine.
Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. www.sagepublishing.com