Summary
Homeopathic treatment seems to have clinical benefits for rheumatoid arthritis. An exploratory double-blind, randomized placebo-controlled clinical trial was conducted to assess the benefits of homeopathic intervention in patients with stable, active rheumatoid arthritis who had been under conventional therapy. These patients came from rheumatology outpatient departments in three UK hospitals. According to the results, a consultation with a homeopathic professional gave a sense of empowerment and empathy to the patients, and is the most important attributable factors for the clinical benefits experienced by rheumatoid arthritis patients, rather than the homeopathic remedies themselves.

Introduction
Rheumatoid arthritis is a chronic inflammatory disease affecting multiple joints in the body with a worldwide prevalence of 1 percent. Homeopathy is a complementary and alternative medical intervention practiced for different medical conditions including rheumatoid arthritis. Studies have shown mixed effects on the clinical benefits of homeopathy in rheumatoid arthritis. There is also evidence of the therapeutic benefits gained from the homeopathic consultation process. “Homeopathy consultations involve a complete exploration of the patient’s emotional, spiritual and physical well-being to enable treatment of the whole person, not just the illness,” per the researchers. The authors therefore tried to identify and explore whether benefits in rheumatoid arthritis are attributable to the homeopathic remedy, the homeopathic consultation or both.

Methodology
•    Patients with an active but stable condition of rheumatoid arthritis taking their conventional medication were randomized into different groups.
•    In one group, the patients received treatment (homeopathic remedies) including consultation; in the other, patients received treatment without consultation.
•    The patients received either both remedies and consultation or remedies only, for a period of 24 weeks, and then the patients in both groups were followed up until week 40.
•    The clinical benefits were assessed by a variety of validated standard scales used to measure patient outcome in arthritis either weekly or monthly.

Key findings
•    Homeopathic consultation with remedies statistically showed significant clinical benefits by an improvement in the measurement of certain scales only, compared to those not receiving a consultation.
•    Homeopathic consultation showed a marked improvement in disease outcome scales, pain assessment scores, patient global assessments and negative moods.
•    Those patients receiving homeopathic consultation reported meaningfully higher scores at the first consultation for enablement and empathy, compared to those receiving no consultation.

Shortcomings
Under-recruitment and a high drop-out rate led to the decrease in patient counts, not allowing for proper assessment of certain disease outcome scales. Moreover, no standardized scale or tool was available for monitoring clinical activity in rheumatoid arthritis when adjunctive treatments were employed with standard treatment. Therefore, modest changes in response to the adjunctive treatment could have been observed. Also, numerous subjective scales were used in the study for assessment which can vary among individuals, and proper interpretation of such data would require multiple studies in the future using the same scales.

Conclusion
This study performed in three UK hospitals identified the benefits patients receive due to homeopathic consultation, significantly improving standard objective markers of rheumatoid arthritis. Homeopathic remedies without consultation proved to have a less effective result than treatment including the consultation process.  “The findings confirm previous work demonstrating that therapeutic benefits do arise from processes within the homeopathic consultation involving communication skills, empathy, hopefulness, enablement and narrative competence. The homeopathic consultation necessitates a very detailed understanding of the patient and is a unique and personalized approach.” Further studies are required to investigate the specific beneficial elements inherent in the homeopathic consultation, which could be employed by other clinicians to maximize patient benefit.

For More Information:
Homeopathy Has Clinical Benefits in Rheumatoid Arthritis Patients Attributable to Consultation and Not the Homeopathic Remedy
Publication Journal: Rheumatology, November 2010
By Sarah Brien; Laurie Lachance; School of Medicine, Aldermoor Health Centre, University of Southampton, UK, and the Center for Managing Chronic Disease, School of Public Health, The University of Michigan, Ann Arbor

*FYI Living Lab Reports Are Summaries of the Original Research.