ABSTRACT
Background: Osteoarthritis is the most common joint disease in humans, which is the greatest cause of physical disability among the elderly in developed countries. Homeopathy is a specific therapy that treats patients based on precise stimulation of the immune and vital systems by certain homeopathy medications. Given the widespread use of this technology, in this article, we compared homeopathy Health Technology with non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis
Methods: In this study, Health Technology Assessment [HTA] was employed to compare homeopathy treatment with non-steroidal anti-inflammatory drugs [NSAIDs], by reviewing clinical trials. The study population included patients with knee osteoarthritis; the intervention group included homeopathy, and the control group comprised routine medical treatment [NSAID] and outcomes measured included efficacy, safety, and cost effectiveness. The most important electronic medical databases were searched for relevant articles published from 2000 to 2016, including The Cochrane Library, Cochrane Central Register of Controlled Trials [CENTRAL]; Center for Reviews and Dissemination, University of York [CRD; NHS EED], Trip; PubMed; EMBASE and Google Scholar
Results: Effectiveness was measured by indicators of pain and motor function. Total changes in VAS index revealed about 34 units decrease in the intervention group, while there was 12 units reduction in the control group. Reducing the consequences of pain and knee function problems were 10 points more in the intervention group in comparison to the control group. Safety outcomes were measured via skin reactions [and sensitivity] which were lower in the intervention group. In terms of cost-effectiveness, the results revealed that for each unit of pain relief, more cost was spent in homeopathy method
Conclusion: Given that the overall costs of both treatments were low, even with the higher effectiveness and safety of homeopathy treatment, compared with NSAIDs, homeopathy is preferable
ABSTRACT
Knee pain Is one of the most common reasons patients visit their physician. In this regard Magnetic Resonance Imaging [MRI] is the tool of preference for diagnosis. The aim of this study was to determine appropriate guidelines for knee MRI administration using the RAND Appropriateness Method [RAM]-2013. This qualitative study was done in the Mashhad University of Medical Sciences in 2013. The most appropriate approved knee MRI administration clinical guidelines were evaluated using Guidelines Evaluation and Research Appraisal [AGREE]. Panel members consisting of six orthopedic and three rheumatologic doctors gave scores ranging from 1 to 9 for each scenario. The indications were grouped as appropriate, equivocal and inappropriate. Data were analyzed by descriptive statistics and SPSS ver. 18 software. Sixty-three scenarios were extracted from the guidelines and then the scenarios were evaluated in 26 indications. Thirty-two [50.79%] cases were considered appropriate, 12 [19.04%] cases uncertain and 19 [30.1%] cases inappropriate. The RAND appropriateness method is helpful in identifying the opinion of stakeholders in health care systems. Moreover, making practical use of clinical guidelines can improve patients' quality of care and prevent un-necessary costs