Based on an article in Spanish by Dr. Gualberto Díaz available here
The Spanish Minister of Health, Consumption and Social Welfare, María Luisa Carcedo, and the Minister of Science, Innovation and Universities, Pedro Duque, presented the #CoNprueba campaign, an initiative that has different communication and awareness actions aimed at making information accessible to citizens so that they can make informed and responsible decisions regarding pseudotherapies and pseudosciences. (click here to see further details)
Curiously the Spanish Government initially failed to define exactly what they meant by pseudo therapies, and this term is proving very hard to define, as if one sticks to those therapies that have demonstrated the highest degree of scientific evidence as some would propose, we are left almost without medicine, since only 20% of recommendations in Primary Care would be supported. (Ebell MH, Sokol R, Lee A, Simons C, Early J. How good is the evidence to support primary care practice? Evid Based Med. 2017 Jun;22(3):88-92)
The campaign has now determined a total of 73 types of therapy that they consider to be pseudo therapies. These include tibetan massage, psychic healing, colon hydrotherapy and indigenous Mapuche medicine (from Chile).
More interesting, they have also compiled a list of 66 therapies which are still under evaluation, including acupuncture, osteopathy, homeopathy and herbalism. However, there is no clear explanation as to the quantity and quality of evidence required for a therapy to be evaluated as positive.
It is worth noting that:
- There is a substantial growing evidence base for homeopathy (eg https://www.hri-research.org/resources/research-databases/)
- Many patients report a certain degree of satisfaction associated with a perception of improvement of symptoms or their well-being or quality of life with the use of different natural therapies (eg https://kundoc.com/pdf-patient-benefit-survey-tunbridge-wells-homoeopathic-hospital-.html .)
- People who use complementary and alternative medicine often do so as a secondary treatment option, as a complement to conventional medicine or as a last resort, making any sort of assessment much more complicated.
- When examining evidence, the issue is further obfuscated by the use of reports such as the infamous NHMRC review of homeopathy which has been taken to the ombudsman because of numerous flaws, notwithstanding the fact that it was based on 5 studies rather than the often-quoted 1800 studies.
- A Health Technology Assessment report on effectiveness, cost-effectiveness and appropriateness of homeopathy was compiled on behalf of the Swiss Federal Office for Public Health (BAG) Swiss in 2006. The results of this concluded that many high-quality investigations of pre-clinical basic research proved homeopathic high-potencies inducing regulative and specific changes in cells or living organisms. 20 of 22 systematic reviews detected at least a trend in favour of homeopathy. In their estimation 5 studies yielded results indicating clear evidence for homeopathic therapy. The evaluation of 29 studies in the domain ‘Upper Respiratory Tract Infections/Allergic Reactions’ showed a positive overall result in favor of homeopathy. 6 out of 7 controlled studies were at least equivalent to conventional medical interventions. 8 out of 16 placebo-controlled studies were significant in favor of homeopathy. Taking internal and external validity criteria into account, effectiveness of homeopathy can be supported by clinical evidence and professional and adequate application be regarded as safe. (https://www.ncbi.nlm.nih.gov/pubmed/16883077)
As the Spanish National Assembly of Homeopathy (ANH) has expressed on numerous occasions, it seems great that an effort be made to protect sick people by preventing them from falling into the hands of deceptive advertising and scammers.
At the same time there seems to be enough data and documents to give homeopathy its proper place as an alternative therapy that, properly used, can help patients along with other conventional and CAM therapies.