References to all included RCTs are available on-line at.

BackgroundThe demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate.MethodsThree groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis.ResultsThe CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC) were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs.ConclusionsCM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to specific diagnoses. Between CM practices differences were found on specific domains of complaints. Visit length was much longer in CM practices compared to mainstream GP visits, and such ample time may be one of the attractive features of CM for patients.

There is a steady increase in patients seeking complementary medicine (CM). Little is known about Dutch CM patients and the extent in which they differ from those of mainstream health care seekers. 1839 consecutive new patients consulting one of 40 CM physicians completed a questionnaire before entering the consulting room. Resulting CM patient data was compared with that from 2784 mainstream general practice patients. Differences in patient profiles were tested using multilevel regression analysis. CM patients most often appeared to report general complaints. Half of them consulted a CM physician because they were looking for information and advice from a different angle. One fifth had doubts about mainstream healthcare. The CM patients foremost expected to be treated as a person and to get ample time to talk. The profiles of the patients attending the different types of CM physicians did not differ much. Compared to mainstream patients, CM patients more often appeared to be female and higher educated. We conclude that, contrary to expectations, patients do not consult a CM physician for reasons of disappointment with mainstream GP care. CM consulters primarily appear to seek a physician who takes time and who treats their complaints from a holistic viewpoint.

An homoeopathic pathogenic trial (HPT, proving) was carried out using a double-blind, placebo-controlled crossover method. The name of the medicine was also unknown to the volunteers. A number of subjects withdrew at the last minute, leading to an unbalanced randomisation. A strong period effect was observed, which makes results difficult to interpret. Most subjects were able to guess correctly which treatment was active and which placebo.

No abstract